scholarly journals Lorazepam As Anxiolytic Sedative Night Before Operation

2012 ◽  
Vol 7 (2) ◽  
pp. 25-28
Author(s):  
ME Karim ◽  
MH Rahman ◽  
MHMD Hossain ◽  
MN Ahsan
Keyword(s):  
Body Weight ◽  
Side Effects ◽  
Military Hospital ◽  
Male Population ◽  
Female Population ◽  
Haemodynamic Parameters ◽  
Elective Surgical Procedures ◽  
Group A ◽  
Group B ◽  
Induction Of Anaesthesia

Introduction: Surgical patients have a high incidence of anxiety and there is a significant inverse relationship between anxiety and smoothness in induction of anaesthesia. The benzodiazepines are very effective at melting away the active terror of anxiety. Diazepam, a long acting benzodiazepine, is widely used by the anaesthesiologist to allay anxiety and provide sedation. The metabolism of diazepam is slow and is depressed by many factors such as old age, disease states (e.g. hepatic cirrhosis) and concomitant drug administration (e.g. cimetidine). Lorazepam, an intermediate acting benzodiazepine, is well absorbed orally. It is conjugated in the liver to the pharmacologically inactive glucuronide and its metabolism is less impaired by the above factors. Objective: To compare the anxiolytic properties of lorazepam with diazepam before elective surgical procedures. Method: One hundred patients of American Society of Anaesthesiologists (ASA) grade I and grade II, who were scheduled for general surgical, gynaecological operative procedures under general and regional anaesthesia in Combined Military Hospital, Saidpur Cantonment, during the period between June 2008 to June 2010, were included in this study. They were randomly distributed into two groups. Subjects of group A (n=50) received diazepam (Sedil) orally in a dose of 5 mg for <30 kg body weight or 10 mg for 30-70 kg body weight or 15 mg for >70 kg body weight. Subjects of group B (n=50) received lorazepam (Ativan) orally in a dose of 2 mg for <30 kg body weight or 4 mg for 30-70 kg body weight or 6 mg for >70 kg body weight. The effects of the two drugs as anxiolytic sedatives were compared on the basis of haemodynamic parameters, side effects and quality of sleep. Results: There was no significant change in haemodynamic parameters between the two groups. Drugs on group B (Lorazepam group) were found to be more anxiolytic than drugs on group A (Diazepam group). Twenty percent of patients in diazepam group complained of moderate anxiety but it was absent in lorazepam group (p<0.01). Six percent of patients were restless/agitated in preoperative period in diazepam group, but it was absent in lorazepam group. Percentage of tranquil patients was significantly higher in lorazepam group (44%) than that in diazepam group (30%). Hangover effect was noted markedly in group B patients (44%) which was nil in group A patients (p<0.01), but it was beneficial for induction of anaesthesia. Moreover this hangover effect was significantly higher (p<0.01) in female population (50%) than in male population (21.05%). Some other side effects like nausea, vertigo were also noticed in patients of both groups and females were more susceptible to these side effects than males which might be an individual variation. Conclusion: Considering all the factors, lorazepam appeared to be a better option than diazepam as anxiolytic sedative night before operation. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10392 JAFMC 2011; 7(2): 25-28

scholarly journals Efficacy of Ivermectin in COVID-19 Patients with Mild to Moderate Disease

2021 ◽  
Author(s):  
Karamat Hussain Shah Bukhari ◽  
Asma Asghar ◽  
Najma Perveen ◽  
Arshad Hayat ◽  
Sermad Ahmad Mangat ◽  
...  
Keyword(s):  
Side Effects ◽  
Standard Of Care ◽  
Viral Clearance ◽  
Secondary Outcome ◽  
Military Hospital ◽  
Laboratory Parameters ◽  
Function Tests ◽  
Moderate Disease ◽  
Group A ◽  
Group B

AbstractObjectiveTo evaluate the efficacy of ivermectin (IVM) as an addition to the standard of care (SOC) treatment in COVID-19 patients with mild and moderate diseaseMaterials and MethodsA randomized clinical trial (Trial registration # NCT04392713) was carried out at Combined Military Hospital Lahore from March 15, 2020, to June 15, 2020. Eighty-six patients with reverse transcriptase-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection completed the trial protocol. Patients were stratified via the lottery method into two groups. Group A was administered standard of care (SOC) treatment as per existing hospital guidelines whereas group B was given ivermectin (single dose of 12 milligrams) along with SOC treatment. PCR was repeated at 72 hours, 7th day, and at 14th day of admission for both the groups and the point at which the PCR became negative was noted. Complete blood counts, liver function tests and renal function tests were done at recruitment, 7th day, and 14th day. The primary outcome was the viral clearance, measured as days to achieve PCR negativity. The secondary outcome was the development of any adverse side effects pertinent to ivermectin or derangement in baseline laboratory parameters.ResultsIn group A, 36 (80%) participants were males, and 9 (20%) were females, whereas in group B, 37 (90.2%) were males and 4 (9.8%) were females. Mean age was 39.0± 12.6 and 42.2 ± 12.0 years for groups A and B, respectively (p= 0.394). There was early viral clearance in group B as compared to group A (p=0.001). No adverse reaction or derangements in laboratory parameters was noted in the intervention arm during the trial period.ConclusionIn the intervention arm, early viral clearance was observed and no side effects were documented. Therefore ivermectin is a potential addition to the standard care of treatment in COVID-19 patients.

scholarly journals OPEN CHOLECYSTECTOMY

2010 ◽  
Vol 17 (02) ◽  
pp. 193-198
Author(s):  
ALI KASHIF ◽  
FAHEEM FEROZE ◽  
WAQAS AHMAD KAZI
Keyword(s):  
Side Effects ◽  
Rescue Medication ◽  
Open Cholecystectomy ◽  
Postoperative Nausea And Vomiting ◽  
Study Drug ◽  
Military Hospital ◽  
Induction Agent ◽  
Group A ◽  
Group B ◽  
Anaesthesia Care

Background: Postoperative nausea and vomiting (PONV) are most common and distressing complications after anaesthesia and surgery, leading to various problems. Metoclopramide, a benzamide, used as an anti-emetic, has got various side-effects. Propofol, a short acting induction agent, possesses anti-emetic properties in sub hypnotic doses, without having unwanted side- effects in this low dose. Objectives: To compare the frequency of PONV in patients treated with propofol and metoclopramide. Study Design: Experimental study. Setting: Department of anaesthesia and intensive care, Combined Military Hospital Rawalpindi. Duration: 06 months (01st July to 31st December 2004). Materials and Methods: 182 female patients scheduled for open cholecystectomy were selected for this study. All of them received general anaesthesia without any prophylactic antiemetic. Out of them, 60 patients who complained of PONV in post anaesthesia care unit (PACU) were selected by non probability convenience sampling and were equally divided into two groups. Group ‘A’ received propofol (0.5 mg/kg) while group ‘B’ received metoclopramide (0.2 mg/kg). Recurrence of PONV was recorded 60 min after administration of the study drug. Patients still complaining of PONV 30 min after administration of the study drug received a rescue medication i.e. I/V ondansetron (4mg). Results: In group “A”,18 patients responded to intervention (60%) whereas 26 (86.66%) patients gave a positive response in group “B” (p 0.020). More patients who received propofol needed the rescue medication (40%) than those who received metoclopramide (13.33%) (p 0.020). Conclusion: Metoclopramide is a better option for managing PONV than propofol. 

scholarly journals Comparative Efficacy of Intrathecal Pethidine with Lignocaine 5% (Heavy) as Sole Anaesthetic Agent for Perineal Operations

2020 ◽  
Vol 5 (1) ◽  
pp. 78-83
Author(s):  
Jitta Sudershan Reddy
Keyword(s):  
Body Weight ◽  
Side Effects ◽  
Postoperative Analgesia ◽  
Anaesthetic Agent ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Motor Paralysis ◽  
Group A ◽  
Group B ◽  
Preservative Free

Background: The discovery of opioid receptors and ligand in the brain and spinal cord lead to the feasibility of their use intrathecally. Pethidine is the only narcotic that has been shown to be effective intrathecally for surgery. This is probably because it as a phenyl-piperidine derivative and has a structure and action similar to that of local anaesthetic.Subjects and Methods:50 patients belonging to ASA grade 1 and 2 physical status were randomly assigned to two groups A and B. Patients in group A received 1 ml of 5% lignocaine (heavy) intrathecally and those in group B gained intrathecal Pethidine (preservative-free) 0.5mg/kg body weight. The time for onset and level of sensory blockade, onset and degree of motor blockade, hemodynamic parameters, time for regression of sensory and motor blockade, duration of postoperative analgesia and side effects were noted and compared in both the groups.Results:Two groups were comparable with respect to age, sex, height and weight. The onset of sensory and motor blockade in-group A was 2.00±1.06min and 2.56±0.88 and in-group B it was 3.56±1.64 min and 7.22±1.11 min respectively, which was statistically significant. Grade I motor paralysis was seen in 2 cases (10%) in group A and 15 cases (75%) in groupB. Grade II motor paralysis was seen in 6 cases (30%) in group A and 5 cases (25%) in group B. Grade III motor paralysis was viewed in 12 cases (60%) in group A and 0 cases(0%) in group B. Grade I and III motor paralysis in the groups were statistically significant (p<0.05). Time for sensory regression at L1 was 65.12±4.83 min in-group A and 94.60±6.88 min in-group B that was statistically very significant (p<0.05). The time for regression of motor blockade was 60.40±3.85 in-group A and 60.20±5.02 in group B, which was statistically not significant (p>0.05). The duration of postoperative analgesia was 122.84±9.37 min in-group A and 320.60±23.02 in group B, which was statistically very significant. The incidence of side effects was comparable in both groups.Conclusion:Pethidine (preservative-free) 0.5mg/kg body weight can be used intrathecally as a sole anaesthetic agent to provide prolonged postoperative analgesia associated with hemodynamic stability and early ambulation in patients undergoing perineal surgeries.

scholarly journals BRACHIAL PLEXUS BLOCK

2016 ◽  
Vol 23 (08) ◽  
pp. 980-984
Author(s):  
Muhbat Ali ◽  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish Suchdev ◽  
Saqib Khan
Keyword(s):  
Body Weight ◽  
Brachial Plexus Block ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Plexus Block

Objectives: The aim of our study is to find out the efficacy of dexamethasone(8mg) on prolonging the duration of motor and sensory blockade as used in brachial plexusblock required for forearm and hand surgeries. Study Design: Prospective randomized doubleblind trial. Period: April 2013 to May 2014, for a period of 14 months. Setting: Tertiary carehospital in Karachi Pakistan. Method: The study population consisted of 42 patients belongingto ASA classification, grades I and II, who underwent elective surgical procedures involving theforearm and hand. The patients were divided in to three groups, group A consisted of patientswho were given 2% of prilocaine at 5mg per kg of body weight, group B consisted of patientswho were given 2% of prilocaine with dexamethasone (8mg as 2ml) at group C consisted ofpatients who were given 0.5% of levobupivacaine at 1.5mg per kg of body weight. The timeduration and onset of sensory and motor blockade was duly noted for all the three groups.Data was analyzed using SPSS version 20. Results: The time of onset of motor and sensoryblock in group A and B, were very similar, there was a difference of longer duration was dulynoted in group C, which was statistically significant (p<0.001). In terms of the duration of block,a statistically significant difference was found when compared in the three groups (p<0.001).The duration of sensory and motor blockade was longer in Group C when compared to theother two groups, and they were found to be longer in group B when compared with group A(p<0.001). Side effects were not found in the study population due to small number of patientsevaluated. Conclusion: According to our study the addition of dexamethasone to the prilocaineused in hand and forearm surgeries resulted in increased duration of the sensory and motorblockade achieved. While levobupivacaine was found to be a very potent anesthetic when usedlocally for post op analgesia requirements and during long procedures.

scholarly journals Tracheal Intubation without Muscle Relaxant Comparison Between Three Techniques

2009 ◽  
pp. 32-35
Author(s):  
M Ali ◽  
KM Iqbal ◽  
AYF Elahi Chowdhury
Keyword(s):  
Side Effects ◽  
Tracheal Intubation ◽  
Muscle Relaxation ◽  
Randomized Study ◽  
Alternative Methods ◽  
Double Blind ◽  
Group A ◽  
Thiopental Sodium ◽  
Group B ◽  
Induction Of Anaesthesia

The standard techniques of tracheal intubation are usually done after induction of anaesthesia followed by skeletal muscle relaxation. The muscle relaxants are associated with many side effects. These side effects have spurred research into development of alternative methods for providing good intubation condition. Forty-five patients with ASA grade I or II, having Mallampati class-I or II airways were divided in three groups depending on administration of drugs in a double blind randomized study. Group-A, thiopental sodium (5mg/kg) + fentanyl (10mcg/ kg) + lignocaine(1mg/kg), Group-B, thiopental sodium (5mg/kg) + fentanyl (10mcg/kg ) and Group-C, thiopental sodium (5mg/kg) + suxamethonium(1mg/kg) Group-C acted as control. The blood pressure and heart rate were measured before induction,after induction and after intubation. Ease of intubation was judged by Scheller intubation criteria. The intubation was possible in all patients of the three groups and there were no significant differences between them in respect to total score.DOI: http://dx.doi.org/10.3329/jbsa.v17i1.4049 Journal of BSA, Vol. 17, No. 1 & 2, 2004 p.32-35

scholarly journals PRETREATMENT WITH LIGNOCAINE

2010 ◽  
Vol 17 (04) ◽  
pp. 633-637
Author(s):  
MOBEEN IKRAM ◽  
MUHAMMAD ISHAQUE ◽  
NAVEED MASOOD
Keyword(s):  
Normal Saline ◽  
Military Hospital ◽  
Double Blind Study ◽  
Double Blind ◽  
Pain On Injection ◽  
Experienced Pain ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Induction Of Anaesthesia

Objective: To assess the frequency of pain and withdrawal movements after injection of rocuronium and effects of pre-treatment with lignocaine. Study Design: Double blind study. Duration of Study: This study was of six months duration and was carried out from March 2004 to September 2004. Setting: Combined Military Hospital Kharian. Patients and Methods: One hundred and twenty unpremedicated patients with ASA grade I and II, aged between 18-60 years and of both sexes were enrolled in the study. Patients were randomly divided into two groups of 60 patients each. After induction of anaesthesia with thiopentone, patients in group A received 3 ml of lignocaine plain while those in group B, received 3 ml of normal saline as pre-treatment before injection of rocuronium. Their effects on pain on injection and withdrawalmovements of the arm were studied. Results: Out of total of 120 patients, only 17 patients (14%) developed withdrawal movements of the arm or wrist. In Group A, who received lignocaine plain before rocuronium injection, only 3 patients out of 60 patients had withdrawal movements while in Group B, who received normal saline as pre-treatment fourteen out of 60 patients developed withdrawal movements of the arm or wrist. Only one patient belonging to Group B experienced pain. Conclusions: Pretreatment with lignocaine plain greatly reduces the chances of withdrawal movements and pain on injection of rocuronium.

scholarly journals ACUTE RENAL COLIC

2010 ◽  
Vol 17 (01) ◽  
pp. 59-63
Author(s):  
MUHAMMAD ALI NAQVI ◽  
Zl MIRZA
Keyword(s):  
Emergency Department ◽  
Side Effects ◽  
Pain Relief ◽  
Diclofenac Sodium ◽  
Military Hospital ◽  
Rescue Analgesia ◽  
Quasi Experimental ◽  
Group A ◽  
Ureteric Colic ◽  
Group B

Objective: To compare the efficacy of Nelbuphine hydrochloride (opioid) and Diclofenac Sodium (NSAID) in management of Acuterenal pain. Design: Prospective non-randomized quasi experimental study. Setting: This study was conducted in Emergency department (ED)of Combined Military Hospital, Lahore. Period: From 1st April 2008 to 31 July 2009. Patients and Method: A Total of 100 patients presentingin emergency department with a clinical diagnosis of renal and Ureteric colic were studied. They were randomly divided in to equal andcomparable groups, Group A & B. Severity of pain was assessed using a Visual Analogue scale (VAS). Group A was treated with IntravenousNelbuphine 10mg and group B was given intramuscular Diclofenac Sodium 75mg. Assessment of Pain relief, both onset and complete responsewas assessed in both groups. In addition to the pain relief, side effects like Nausea, vomiting, respiratory depression, drowsiness and injectionsite pain were also assessed. Results: Nelbuphine was found significantly superior (p=0.05) to Diclofenac, both for time of onset of pain reliefand complete pain relief. Moreover less patients required rescue analgesia in Group A (p=0.05). Only one patient treated with Group A hadrespiratory depression which was statistically insignificant (p=0.05). There was a 3.5% increase in Nausea and vomiting in Nelbuphine treatedpatients. Conclusion: Nelbuphine is a safe and rapid acting Opioid with few side effects. It should be preferred over Diclofenac sodium intreatment of Acute Renal pain.

Pregabalin As A Premedicant To Attenuate Pressor Response In Patients Undergoing Laparoscopic Cholecystectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

2020 ◽  
Vol 11 (3) ◽  
pp. 3418-3423
Author(s):  
Sweety Agrawal ◽  
Shubdha Bhagat ◽  
Pratibha Deshmukh ◽  
Amol Singham
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pressor Response ◽  
Controlled Study ◽  
Double Blind ◽  
Co2 Insufflation ◽  
Ramsay Sedation Scale ◽  
Minute Interval ◽  
Group A ◽  
Group B ◽  
Induction Of Anaesthesia

The present study was done to evaluate the ability of oral pregabalin to attenuate the pressor response to airway instrumentation in patients undergoing laparoscopic cholecystectomy under general anesthesia. Sixty-four adult patients aged between 25-55 year of either gender belonging to ASA-1 or ASA2 physical status weighing 50-70 kg were enrolled in this study. Thirty-two patients each were randomized to group A, or group B. Patients in group A received tablet Pregabalin (150mg) and those in group B received placebo orally one hour before induction of anaesthesia. Heart rate, blood pressure, and sedation were assessed preoperatively before giving the tablets and after 30 minutes, and just before induction of anaesthesia. Intraoperative, pulse rate, mean arterial pressure, ECG in the lead II, SPO2 and ETCO2 were monitored. All the above parameters were noted during laryngoscopy and intubation, 3 minutes after CO2 insufflation, and then at every 10-minute interval till the end of surgery. These parameters were also recorded after extubating the patient. The Ramsay sedation scale was used to assess the sedation at the baseline, one hour after drug intake , one hour after extubation and 4 hour after surgery. Any adverse effects in the postoperative period were recorded. The result of our study shows that pre-emptive administration of oral pregabalin 150 mg significantly reduced the pressor response at the time of laryngoscopy and intubation, after CO2 insufflation and just after extubation. We conclude that oral pregabalin premedication is effective in successful attenuation of hemodynamic pressor response to laryngoscopy, intubation and pneumoperitoneum in patients undergoing laparoscopic cholecystectomy

scholarly journals Morphological and histopathological study of hypertrophied inferior nasal turbinate in Egyptian patients: in clinical perspective

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ashraf Ali El-Demerdash ◽  
Essam Abdel Wanees Beheiry ◽  
Sherif Maher El-Aini ◽  
Asmaa Shams El-Dein Mohamed ◽  
Ahmed Mohamed Ibrahim Khattab
Keyword(s):  
Layer Thickness ◽  
Nasal Septum ◽  
Inferior Turbinate ◽  
Military Hospital ◽  
Deviated Nasal Septum ◽  
Nasal Turbinate ◽  
Egyptian Patients ◽  
Mucosal Layer ◽  
Group A ◽  
Group B

Abstract Background The inferior nasal turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. Hypertrophied inferior nasal turbinates are the second most common cause of chronic nasal obstruction. Our aim of this study is to evaluate the morphological and histopathological features of hypertrophied inferior nasal turbinate in Egyptian patients. Methods Our descriptive comparative study was carried on 30 patients presented with hypertrophied inferior nasal turbinate by clinical and radiological assessment. Patients are divided into two groups according to CT scan and endoscopic examination as group A for patients with deviated nasal septum with compensatory hypertrophied inferior nasal turbinate and group B for patients with hypertrophied inferior nasal turbinate due to allergic rhinosinusitis. Both groups underwent the same operation which partial controlled posterior inferior turbinectomy. During the period from June 2018 till May 2019, patients were selected from out-patient’s clinic of Otorhinolaryngology Department at Menoufia University Hospital and Shebin El-Kom Teaching Hospital, and Military Hospital. Results By histopathological examination of the specimens, we found out that the bony layer thickness was more prominent in group A and the mucosal layer thickness was more prominent in group B. The prominent inflammatory cells were lymphocytes in group A and eosinophils plus mast cells in group B. Conclusion The bony layer thickness should be excised during the surgical treatment of cases presented with deviated nasal septum with hypertrophied inferior turbinate where in cases of allergic rhinitis with hypertrophied inferior turbinate, the mucosal layer is enough to be excised.

scholarly journals A PROSPECTIVE STUDY TO ANALYSE THE SIDE EFFECTS OF OLMESARTAN MEDOXOMIL AND ENALAPRIL IN HYPERTENSIVE SUBJECTS

2018 ◽  
Vol 11 (12) ◽  
pp. 258
Author(s):  
Parminderpal Singh ◽  
Kiranjit Kiranjit
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Postural Hypotension ◽  
Olmesartan Medoxomil ◽  
National Commission ◽  
Group A ◽  
Group B ◽  
Taste Alteration ◽  
A Prospective Study

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.

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