scholarly journals Comparing Intravenous Dexamethasone, Pethidine, and Ketamine for Postoperative Shivering Prevention in Patients Undergoing General Anesthesia

2021 ◽  
Vol 27 (3) ◽  
pp. 288-301
Author(s):  
Mohsen Saheban Maleki ◽  
◽  
Sepide Sedaghati Ansari ◽  
Fateme Rezaniazave ◽  
Alireza Talai ◽  
...  

Aims: Postoperative shivering is unpleasant and annoying for the patient, occurring in up to 65% of cases undergoing general anesthesia. Various mechanisms were suggested for postoperative shivering. Shivering after anesthesia can cause complications, such as cardiovascular conditions, bleeding, and infection. This study compared the effects of dexamethasone, pethidine, and ketamine on the prevention of shivering after general anesthesia. Methods & Materials: In total, 164 patients with ASA classes one and two in the age range of 20-60 years under general anesthesia with orthopedic surgery, urology, and general surgery were included in the study. This study was a double-blind, randomized, placebo-controlled study. The study patients were divided into 4 groups of 41 subjects. After the induction of anesthesia and before surgery, in the first group, dexamethasone 0.15 mg/kg body weight, in the second group, ketamine 0.5 mg/kg, in the third group, pethidine 0.5 mg/kg, and in the fourth group, normal saline 0.9% were all given in 2 cc volume. After surgery, the examined patients were monitored for visible shivering by the researcher. The obtained data were analyzed using SPSS. Findings: The frequency and severity of shivering were lower in the dexamethasone (P=0.009), pethidine (P=0.004), and the ketamine (P=0.000) groups, compared to the control group. Besides, there was a significant difference between each of these 3 groups and the controls. The frequency and severity of shivering in the dexamethasone group were not significantly different from those of the pethidine group (P=0.565). The frequency and severity of shivering in the dexamethasone and ketamine groups were not statistically significant (P=0.071). The frequency and severity of shivering in the pethidine group with ketamine were not statistically significant (P=0.063). Conclusion: The obtained results indicated that dexamethasone, pethidine, and ketamine were effective in preventing postoperative shivering. There was no difference between these medications in the prevention of postoperative shivering.

1996 ◽  
Vol 24 (6) ◽  
pp. 674-677 ◽  
Author(s):  
K. L. Schwager ◽  
D. B. Baines ◽  
R. J. Meyer

The stimulation of the acupuncture point P6 has been used to prevent nausea and vomiting in the adult population. It has, however, been subject to limited comparative evaluation in children. We proposed that stimulation of P6 and the analgesic point Li4 would reduce the incidence of postoperative vomiting. Eighty-four unpremedicated paediatric patients having day-stay surgery (circumcision or herniotomy/orchidopexy) were included in a randomized, double-blind, placebo-controlled study of transcutaneous stimulation of P6 and Li4 or no stimulation. The incidence of vomiting was recorded for 24 hours postoperatively. There was no statistically significant difference in total postoperative vomiting in those patients who were stimulated, compared with the control group (P=0.909), or between any group for postoperative vomiting in the recovery ward, day-stay ward or at home. For all groups, vomiting was more common within the first four hours and more likely to occur in the day-stay ward.


2018 ◽  
Vol 5 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Sujita Manandhar ◽  
Kishor Manandhar ◽  
Sharad Khakrel

Introductions: Postoperative sore throat (POST) is a commonly seen adverse event after general anesthesia with endotracheal intubation. Dexamethasone, a potent corticosteroid with anti-inflammatory action is the most popular steroid studied in this regard with positive results. Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on one hundred and ten adult patients of either sex, American Society of Anesthesiologists physical status I & II, undergoing elective surgeries requiring endotracheal tube intubation. After obtaining written informed consent, they were randomly divided into Control (A, n=55) and Dexamethasone (B, n=55) groups and received either an injection of Dexamethasone (Group B) 8 mg intravenously or an equivalent volume of Normal Saline (Group A) just before entering the operating theatre. All the patients received a similar anesthesia with endotracheal tube intubation and at the end of surgery, extubated and transferred to the post-anesthesia care unit. The incidence and severity of sore throat were assessed at 1, 6 and 24 hours post-extubation. Severity of sore throat were graded on a 4 point scale, p <0.05 was considered significant. Results: Incidence of POST in Dexamethasone group was found significantly low compared to the control group up to six hours (p<0.05) but was comparable at 24 hours post extubation. Severity of POST in the study group was of lower grade in compare to control group. Conclusions: Prophylactic intravenous Dexamethasone 8 mg administered to patients undergoing elective surgeries requiring endotracheal tube intubation significantly reduces the incidence and severity of POST up to six hours post-extubation.


2019 ◽  
Vol 20 (4) ◽  
pp. 856 ◽  
Author(s):  
Rafal Kaminski ◽  
Marta Maksymowicz-Wleklik ◽  
Krzysztof Kulinski ◽  
Katarzyna Kozar-Kaminska ◽  
Agnieszka Dabrowska-Thing ◽  
...  

Meniscal tears are the most common orthopaedic injuries, with chronic lesions comprising up to 56% of cases. In these situations, no benefit with surgical treatment is observed. Thus, the purpose of this study was to investigate the effectiveness and safety of percutaneous intrameniscal platelet rich plasma (PRP) application to complement repair of a chronic meniscal lesion. This single centre, prospective, randomized, double-blind, placebo-controlled study included 72 patients. All subjects underwent meniscal trephination with or without concomitant PRP injection. Meniscal non-union observed in magnetic resonance arthrography or arthroscopy were considered as failures. Patient related outcome measures (PROMs) were assessed. The failure rate was significantly higher in the control group than in the PRP augmented group (70% vs. 48%, P = 0.04). Kaplan-Meyer analysis for arthroscopy-free survival showed significant reduction in the number of performed arthroscopies in the PRP augmented group. A notably higher percentage of patients treated with PRP achieved minimal clinically significant difference in visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) symptom scores. Our trial indicates that percutaneous meniscal trephination augmented with PRP results in a significant improvement in the rate of chronic meniscal tear healing and this procedure decreases the necessity for arthroscopy in the future (8% vs. 28%, P = 0.032).


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Varah Yuenyongviwat ◽  
Chaturong Pornrattanamaneewong ◽  
Thitima Chinachoti ◽  
Keerati Chareancholvanich

Background. Local periarticular injection with bupivacaine alone in TKA has not been studied. Thus, we aimed to examine the effectiveness of local periarticular injection with bupivacaine for post-operative pain control in TKA.Method. Sixty patients undergoing TKA by a single surgeon were randomly assigned into two groups in a double-blind, placebo-controlled study. In the injection group, patients received periarticular injections with 0.25% bupivacaine before wound closure; in the control group, patients received a 0.9% normal saline injection. Both groups received the same anesthetic procedure, post-operative pain control, and rehabilitation protocol.Results. There was a significant reduction in post-operative morphine consumption in the first six hours after the operation (mean 0.9 mg and 2.43 mg,P=0.01), but there was no significant difference in post-operative morphine consumption between six hours and ninety-six hours after the operation, visual analogue scale (VAS) score, morphine side effects during the first 96 hours, length of hospital stay, or complications from morphine consumption.Conclusion. Local periarticular injection with bupivacaine alone before wound closer was shown to be an effective method to improve pain control after TKA with a few complications and ease of use.


2015 ◽  
Vol 39 (1) ◽  
pp. 49-55
Author(s):  
Abbas Razzaq Abed

     This study was conducted to demonstrate the effect of Metoprolol on chicken embryos during the period of cuddling automated .This study was completed in Babylon hatchery dedicated to the production of chick chickens, which is located in the province of Babylon. One hundred eggs (Belgian origin, CZ 1924) were divided into equal four groups. The first group injected eggs by Metaprolol at dose 10 mg /70kg BW, and the second group eggs was injected by Metoprolol at dose 15 mg /70kg BW, while eggs in the third group was injected by physiological normal saline only and the fourth group did not inject their eggs any material and considered the control group and all the eggs used in this experiment to take on the fourth day of cuddling. The results of this study showed a decrease in the percentage hatching in groups injected with Metoprolol (T1 and T2 groups, 4% and 13%, respectively) compared to the T3 and the control groups. Also showed the results of the current study, no significant difference at the level of (P <0.05) in the weights of embryos after hatching. While histopathological examination showed the presence of pathological lesions in the heart tissue in injected eggs groups by Metoprolol (T1 and T2 groups) and included these changes infiltration of inflammatory cells, thickening in epicardium and the presence of vacuolation in heart tissue with the appearance of edema, heart tissue damage, congestion in the blood vessels and the occurrence of hemorrhage.


2021 ◽  
Author(s):  
Zhengzheng Gao ◽  
Jianmin Zhang ◽  
Xiaolu Nie ◽  
Xiaohuan Cui

Abstract Background: Emergence agitation (EA) has a negative effect on recovery from general anesthesia in children. Objectives: This study aimed to evaluate the effectiveness of intravenous ibuprofen in reducing the incidence of EA in children.Methods: This randomized, double-blind, placebo-controlled study analyzed data from patients aged 3–9 years undergoing tonsillectomy with propofol general anesthesia. These patients were randomly assigned to receive either the ibuprofen or the placebo intraoperatively. The primary endpoint was between-group difference in the incidence of EA after surgery. EA was defined as Pediatric Anesthesia Emergence Delirium score ≥ 10. The secondary endpoint included the associated factors of EA.Results: Eighty-nine patients were included in the study. Ibuprofen decreased the incidence of EA (8.9% in the treatment group vs. 34.1% in the control group; odds ratio [OR], 0.261; 95% confidence interval [CI], 0.094–0.724; P = 0.004). After the logistic regression analysis, anxiety behavior pre-anesthesia and high pain score after surgery were the risk factors related to EA (OR, 8.07; 95% CI, 1.12–58.07, P = 0.038 and OR, 2.78; 95% CI, 1.60–4.82, P < 0.001, respectively). Ibuprofen administration was the protective factor related to EA (OR, 0.05; 95% CI, 0.01–0.67, P = 0.023).Conclusions: In our studied cohort, intraoperatively infusing ibuprofen and relieving preoperative anxiety and postoperative pain can significantly reduce the incidence and severity of EA after propofol general anesthesia.Trial registration: ChiCTR2100045128 (07/04/2021)


2016 ◽  
Vol 40 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Hisham Y El Batawi ◽  
Ahmed A Shorrab

Background: Postoperative Nausea and Vomiting (PONV) is a common complication following dental treatment under general anesthesia (DGA) that may lead to unplanned hospitalization, increased costs and dissatisfaction of parents. Aim: To investigate the incidence of Postoperative Vomiting (POV) on children who underwent dental rehabilitation under general anesthesia and to compare possible preventive effect of Dexamethasone and Ondansetron on occurrences of POV. Study design: A double blind randomized parallel clinical trial was carried out on 352 ASA I children who underwent DGA in a private Saudi hospital in Jeddah. Children were allocated randomly to four groups. Group D of 91 children, received Dexamethasone PONV prophylaxis, group O of 87 children received Ondansetron, group DO of 93 children received combination of the two drugs and group C the control group of 81 children. The three groups were investigated by blinded dental staff for POV episodes, number of times analgesia was needed and post anesthesia care unit time (PACUT). Results: There was a no significant difference between the two drugs on POV. There was a significant difference in POV between control group and groups D, O, and DO. There was significant reduction in need for analgesia in the Dexamethasone groups. The three groups, which had PONV prophylaxis, showed significant reduction in PACUT compared to control group. Conclusions: Antiemetic drugs are useful adjuncts in DGA. Some dental procedures may have higher emetic potential than others. The type of dental procedures done is to be considered when deciding the drug profile in children undergoing DGA.


2004 ◽  
Vol 45 (1) ◽  
pp. 55-66
Author(s):  
A. M.H. AL-Judi ◽  
R. H. Hameed ◽  
A. D. Salman

This study was done on 57 Awassi pregnant ewes, divided in to 5 groups, the 1st control group, the second group received  E (900 mg) and Selenium (3mg), twicel.M.injections of vitamin the third group received one injection of vitamin E (900mg) and  feed  via selenium ( 3 mg), the fourth group received vitamin E block (1 gm) daily for two weeks, the fifth group received  vitamin E via feed block for one week (1gm daily), and all groups injected with C Baghdad vaccine.  This study had been shown a significant difference in antibody titer between treated groups and the control group, from2weeks post  titre vaccination There were significant difference in antibody (p<0.05) between lambs of treated and control group. While there were no significant difference in body weight of ewes and lambs,  production of treated and but was a significant difference in milk control group. 


Author(s):  
Seetharaman Hariharan

Objectives Dexamethasone, in the dose of 8 mg or higher, has been advocated to be used as an adjuvant to prolong the duration of brachial plexus blocks with local anaesthetics. This study aimed to test the hypothesis that a lower dose of dexamethasone (4 mg) added to bupivacaine would prolong the duration of analgesia in brachial plexus blocks. Methods A randomized double-blind placebo-controlled trial was conducted on patients who underwent supraclavicular brachial plexus blocks using an ultrasound. Patients were randomized to receive 19 mL of 0.5% bupivacaine with dexamethasone (4 mg) (study group) and saline (1 mL) (control group). Primary outcome measure was the duration of analgesia. Onset and duration of sensory, motor blocks, postoperative 24-hour morphine requirements were also recorded. Results A total of 46 patients were studied with 24 patients in the dexamethasone group and 22 patients in the control group. Demographic data, type and duration of surgery were comparable between the groups. Dexamethasone group patients had significantly longer duration of analgesia [Mean (SD): 19.8 (3.8) hours], compared to control group patients [Mean (SD): 14.5 (4.2); p< 0.001]. Morphine requirements over a 24-hour period were not significantly different between the groups. Conclusion Low-dose dexamethasone significantly prolongs the duration of analgesia when used with bupivacaine in supraclavicular brachial plexus blocks, although it does not significantly decrease the overall opioid requirements for 24 hours postoperatively.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mine Celik ◽  
Aysenur Dostbil ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ali Ahiskalioglu ◽  
...  

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.


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