scholarly journals Management of Pain During Propofol Injection Using Intravenous Nitroglycerine

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 202-205
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Md Anisur Rahman Babu ◽  
Afsana Sultana ◽  
Md Sirajul Islam Mahfuz ◽  
...  
Keyword(s):  
Placebo Group ◽  
Venous Occlusion ◽  
Saline Group ◽  
Injection Pain ◽  
Group A ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection. Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection. Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale. Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p<0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p<0.05). Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo. KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205

scholarly journals Use of Dexmedetomidine for Preventing Pain on Propofol Injection: A Double Blinded Placebo Controlled Study

2019 ◽  
Vol 10 (2) ◽  
pp. 164-168
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Md Mahiuddin Alamgir ◽  
Md Waliullah ◽  
Paresh Chandra Sarker ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Randomized Study ◽  
Venous Occlusion ◽  
Saline Group ◽  
Controlled Study ◽  
Medical College ◽  
Elective Surgical Procedure ◽  
American Society ◽  
Double Blinded ◽  
American Society Of Anesthesiologists

Background and aim of study: Propofol is a commonly used drug for general anesthesia. It can irritate the skin, mucous membrane and venous intima. The main drawback is the pain during intravenous injection.  Aim of this prospective randomized study is to observe the efficacy of intravenous dexmedetomidine as  pretreatment for the prevention of pain caused by the propofol injection. Methods: A total of 80 adult patients were selected in this study with either sex, ASA (American Society of  Anesthesiologists) grade I and II, scheduled for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group received 0.25 mcg of intravenous dexmedetomidine in 5 ml. Group II (placebo group) received 5 ml of  0.9% intravenous normal saline one minute before injection of propofol. The patients were asked to report  their pain during injection of propofol according to the McCririck and Hunter scale. Results: The incidence of pain experienced in dexmedetomidine group was 35% patients and in saline  group was 70% patients (p<0.05). The severity of POPI was also lower in dexmedetomidine group than  the saline group (p<0.05). The incidence of mild and moderate pain in dexmedetomidine groups versus  saline group was 20% versus 45% and 15% versus 25% respectively p<0.05. There was no severe pain  recorded in any groups. Conclusion: Pretreatment with 0.25 mcg/kg of dexmedetomidine with venous occlusion for one minute,  effectively reduces pain on propofol injection. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 164-168

scholarly journals Patient-Controlled Epidural Levobupivacaine with or without Fentanyl for Post-Cesarean Section Pain Relief

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shin-Yan Chen ◽  
Feng-Lin Liu ◽  
Yih-Giun Cherng ◽  
Shou-Zen Fan ◽  
Barbara L. Leighton ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
University Hospital ◽  
Control Regimen ◽  
Background Infusion ◽  
Continuous Background ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
American Society Of Anesthesiologists

Purpose.The purpose of this study was to compare the analgesic properties of levobupivacaine with or without fentanyl for patient-controlled epidural analgesia after Cesarean section in a randomized, double-blinded study.Methods.We enrolled American Society of Anesthesiologists class I/II, full-term pregnant women at National Taiwan University Hospital who received patient-controlled epidural analgesia after Cesarean section between 2009 and 2010. Eighty women were randomly assigned into two groups. In group A, the 40 subjects received drug solutions made of 0.6 mg/ml levobupivacaine plus 2 mcg/ml fentanyl, and in group B the 40 subjects received 1 mg/ml levobupivacaine. Maintenance was self-administered boluses and a continuous background infusion.Results.There were no significant differences in the resting and dynamic pain scales and total volume of drug used between the two groups. Patient satisfaction was good in both groups.Conclusion.Our study showed that pure epidural levobupivacaine can provide comparative analgesic properties to the levobupivacaine-fentanyl combination after Cesarean section. Pure levobupivacaine may serve as an alternative pain control regimen to avoid opioid-related adverse events in parturients.

Comparison of stent related symptoms in patients taking mirabegron, solifenacin, or tamsulosin: A double blinded randomized clinical trial

2021 ◽  
pp. 039156032110481
Author(s):  
Abhishek Chandna ◽  
Santosh Kumar ◽  
Kalpesh M Parmar ◽  
Aditya P Sharma ◽  
Sudheer K Devana ◽  
...  
Keyword(s):  
General Health ◽  
Bodily Pain ◽  
Ureteroscopic Lithotripsy ◽  
Health Indices ◽  
Pain Scores ◽  
Robotic Pyeloplasty ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
To Receive

Background: The present study aims to assess the efficacy of mirabegron, a novel beta-3 agonist for ameliorating stent related symptoms (SRSs) as compared to tamsulosin and solifenacin. Methods: Total of 150 patients undergoing ureteral stent placement following ureteroscopic lithotripsy, percutaneous nephrolithotomy, or laparoscopic/robotic pyeloplasty were randomized in 1:1:1 fashion to receive mirabegron 50 mg (group A), solifenacin 5 mg (group B), and tamsulosin 0.4 mg (group C) OD respectively. Patients were followed at POD10 (I visit), 4 weeks (II visit) after surgery, and 2 weeks post-stent removal. Validated vernacular version of ureteric stent symptoms questionnaire (USSQ) was administered to the patients at each visit. Results: Out of 150 patients randomized, 123 patients (A; n = 41, B; n = 40, and C; n = 42) completed the study. The groups were comparable in terms of urinary index score of USSQ at I and II visits ( p = 0.119 and 0.076, respectively). A lower proportion of patients in group B experiencing bodily pain at II visit ( p = 0.039), however, pain scores were comparable. Significantly lower general health index scores were observed in group A at I visit and over 4 weeks ( p = 0.007). No significant differences were observed in other domains of USSQ. Age, sex, and surgical procedure undertaken did not significantly impact the scores in various USSQ domains. Conclusion: Mirabegron demonstrates comparable benefit in alleviating SRSs with better general health indices and may be an effective alternative for SRSs, especially when tamsulosin or solifenacin are contra-indicated or poorly tolerated.

scholarly journals Effect of Intravenous Dexamethasone on Propofol Injection Pain: A Randomized Placebo Controlled Study

2020 ◽  
Vol 25 (1) ◽  
pp. 28-33
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Monirul Islam ◽  
Anisur Rahman Babu ◽  
...  
Keyword(s):  
Normal Saline ◽  
Saline Group ◽  
Controlled Study ◽  
Injection Pain ◽  
Moderate Pain ◽  
Dexamethasone Group ◽  
Group I ◽  
Elective Surgical Procedure ◽  
American Society ◽  
American Society Of Anesthesiologists

Background and aim of study: Pain on propofol injection (POPI) is a common problem. None of the commonly used methods completely attenuate the pain. Inflammatory response to propofol contributes to the pain. This study was conducted to compare the efficacy of dexamethasone in attenuation of pain following intravenous injection of propofol. Materials and methods: A total of 80 adult patients were scheduled in this study with either sex, ASA (American Society of Anesthesiologists) grade I and II, for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 0.15 mg/kg of intravenous dexamethasone in 5 ml normal saline and Group II (placebo group) received 5 ml of 0.9% intravenous normal saline, following exsanguination and occlusion of the vein of the arm. This was followed by 0.5 mg/kg of propofol intravenously.The patients were asked to report their pain during injection of propofol according to the McCririck and Hunter scale. Results: The incidence of pain experienced in dexamethasone group was 45% patients and in saline group was 70% patients (p<0.05). The severity of POPI was also lower in dexamethasone group than the saline group (p<0.05). The incidence of mild and moderate pain in dexamethasone groups versus saline group was 30% versus 45% and 15% versus 25% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Pretreatment with intravenous dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain on propofol injection (POPI). Bangladesh J Otorhinolaryngol; April 2019; 25(1): 28-33

The Peripheral Analgesic Effect of Meperidine in Reducing Propofol Injection Pain Is Not Naloxone-Reversible

1998 ◽  
Vol 23 (2) ◽  
pp. 197-200 ◽  
Author(s):  
Wei-Wu Pang ◽  
Martin S. Mok ◽  
Shyuan Huang ◽  
Yung-Tai Chung ◽  
Min-Ho Hwang
Keyword(s):  
Analgesic Effect ◽  
Venous Occlusion ◽  
Injection Pain ◽  
Double Blind ◽  
Perioperative Analgesia ◽  
Tourniquet Release ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Blind Manner

Background and ObjectivesMeperidine is frequently used in general anesthesia and perioperative analgesia. In addition to its opioid action, meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidine to be more effective in reducing propofol injection pain than fentanyl or morphine, both of which were slightly better than placebo. This study was undertaken to evaluate whether this peripheral analgesic effect of meperidine is affected by naloxone.MethodsIn a randomized, double-blind manner, after venous occlusion with a tourniquet, meperidine 40 mg was given intravenously to patients in group A (n = 31), meperidine 40 mg followed by naloxone 0.04 mg to group B (n = 32), meperidine 40 mg followed by naloxone 0.2 mg to group C (n = 30), and normal saline placebo to group D (n = 30). The venous retention of drug(s) was maintained for 1 minute, followed by tourniquet release and intravenous administration of propofol 100 mg. Pain assessment was made immediately after the propofol injection.ResultsAll three groups given meperidine had significantly less propofol injection pain (P < .01) than the group given saline placebo, and there was no difference among groups A, B, and C.ConclusionThe peripheral analgesic effect of meperidine in reducing propofol injection pain is not mediated by its opioid activity.

scholarly journals EFFICACY OF ATRACURIUM VERSUS CISATRACURIUM IN PATIENTS UNDERGOING RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURE UNDER GENERAL ANAESTHESIA – A COMPARATIVE STUDY

2020 ◽  
pp. 197-201
Author(s):  
ALISHA SAHU ◽  
SAMBEET SWAIN ◽  
SOUMYA SAMAL ◽  
SIBANARAYAN MOHANTY
Keyword(s):  
Adverse Effects ◽  
Rapid Onset ◽  
Hemodynamic Parameters ◽  
Onset Of Action ◽  
Duration Of Action ◽  
Group A ◽  
American Society ◽  
Group B ◽  
Time Required ◽  
American Society Of Anesthesiologists

Objectives: The objectives of the study were to compare the efficacy of injection atracurium 0.5 mg/kg intravenous (IV) versus injection cisatracurium 0.2 mg/kg IV for intubation in patients undergoing endoscopic retrograde cholangiopancreatography procedure (ERCP). Methods: Hundred adult patients of both sexes in the age group of 18–60 years belonging to the American Society of Anesthesiologists I/II category posted for ERCP procedures under general anesthesia were randomly allocated into two groups of 50 each. Group A received injection atracurium besylate 0.5 mg/kg intravenously and Group B received injection cisatracurium besylate 0.2 mg/kg intravenously. Parameters observed were time to the maximum blockade, intubating condition, time required for intubation, duration of action, hemodynamic parameters during intubation, and after 1, 2, 3, 5, and 15 min and any adverse effects. Results: Demographic profile was comparable between the groups. Intubating condition as per Cooper et al. score was excellent in 36 patients in cisatracurium group as compared to 19 patients in atracurium group. The overall intubating condition was found to be better in Group B (p=0.00001). Time to the maximum blockade was significantly high with atracurium as compared to cisatracurium. The mean of intubation time was less with cisatracurium (135±11.1) than that of atracurium (144±9.48) in seconds, which was statistically significant. Duration of neuromuscular blockade was found to be prolonged in Group B as compared to Group A (p=0.000). Hemodynamic parameters during intubation and after 1, 2, 3, 5, and 15 min were comparable between the groups. No adverse effect was seen in both groups. Conclusion: Cisatracurium 0.2 mg/kg provides excellent intubating conditions with rapid onset of action, longer duration of action, and no significant hemodynamic changes as compared with atracurium 0.5 mg/kg for ERCP procedures without any adverse effects.

scholarly journals Intrathecal clonidine added to small-dose bupivacaine prolongs

2013 ◽  
Vol 6 (1) ◽  
pp. 25
Author(s):  
Agreta Gecaj-Gashi ◽  
Hasime Terziqi ◽  
Tune Pervorfi ◽  
Arben Kryeziu
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Sensory Block ◽  
Analgesia Requirement ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
Intrathecal Clonidine ◽  
American Society Of Anesthesiologists

Introduction: The aim of this prospective, double-blinded studywas to investigate the effects of clonidine in co-administrationwith bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects.Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I-II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 μg intrathecally. We performed the spinal anesthesia at a level of L3-L4 with a 25-gauge needle. We assessed the sensory block with a pinprick,the motor block using the Bromage scale, analgesia with thevisual analog scale and sedation with the modified Wilson scale.We also recorded the hemodynamic and respiratory parameters.Results: The groups were demographically similar. The mean time of achievement of moto block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded.Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects.

scholarly journals Comparison of oxycodone hydrochloride and sufentanil used in painless fiberbronchoscopy

2018 ◽  
Vol 16 ◽  
pp. 205873921877420
Author(s):  
Ke Zhang ◽  
Tianke Xiao ◽  
Zuqi Chen ◽  
Shuguang Xiong ◽  
Xiaohong Wang
Keyword(s):  
Heart Rate ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Vital Signs ◽  
Fiberoptic Bronchoscopy ◽  
Group A ◽  
Oxycodone Hydrochloride ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists

The study was designed to understand the effects of oxycodone hydrochloride and sufentanil used in painless fiberoptic bronchoscopy. A total of 90 patients aged 3–84 years undergoing painless fiberoptic bronchoscopy were selected, American Society of Anesthesiologists (ASA): I–III criteria—the equal number of subjects were randomly divided into sufentanil group (group A) and oxycodone hydrochloride group (group B). The vital signs, surgical examination and anesthesia, the effect of anesthesia, and adverse reactions were compared between the two groups during the operation. The change of heart rate and changes of hemodynamics in group B were found to be lower than in group A. The number of breaths was significantly lower than group B. The decrease of SpO2 in group A was higher than in group B. Cases of SpO2 <90% was higher in group A than in group B. The dosage of propofol and the recovery time in group A was significantly higher than in group B. The incidence of nausea and vomiting in group A was higher than in group B. Oxycodone hydrochloride combined with propofol used in painless fiberoptic bronchoscopy could improve the safety and efficiency of analgesia compared to sufentanil combined with propofol. The effect was found to have stable hemodynamics and fewer adverse reactions.

scholarly journals PERBANDINGAN PEMBERIAN LIDOKAIN 2% INTRAVENA DENGAN FENTANIL INTRAVENA SETELAH ANESTESI UMUM DIHENTIKAN TERHADAP KEJADIAN BATUK SAAT EKSTUBASI SADAR

2020 ◽  
Vol 8 (2) ◽  
pp. 256
Author(s):  
Dedy Hendra Gunawan
Keyword(s):  
General Anesthesia ◽  
Abdominal Pressure ◽  
Physical Status ◽  
Oral Intubation ◽  
Patient Discomfort ◽  
Group A ◽  
Coronary Ischemia ◽  
American Society ◽  
Group B ◽  
American Society Of Anesthesiologists

Cough after extubation not only causes patient discomfort, but can also cause hypertension, tachycardia, increased intracranial, intraocular, and intra-abdominal pressure, which can cause coronary ischemia, arrhythmia, or surgical difficulties. Cough after extubation can be prevented with several drugs. The purpose of this study is to compare the effects of lidocaine 2% 1.5 mg / kg intravenously compared to fentanyl 1 mcg / kg intravenously in reducing the incidence of cough during conscious extubation. Research conducted on 36 patients aged 18-65 years with the physical status of the American Society of Anesthesiologists (ASA) I and II who performed operations with general anesthesia using oral intubation in a position during supine surgery and correctly extubated. Patients were divided into 2 groups: group A received fentanyl 1 mcg / kg and group B received lidocaine 2% 1.5 mg / kg. The results of the study concluded that 2% lidocaine at a dose of 1.5 mg / kg better in coughing and rejected haemodynamics compared to fentanyl at a dose of 1 mcg / kg at the time of extubation was understood to be moderate.

scholarly journals Efficacy of prophylactic intravenous ondansetron for attenuation of pain on propofol injection

2019 ◽  
Vol 6 (1) ◽  
pp. 31-36
Author(s):  
Sujita Manandhar ◽  
Kishor Manandhar
Keyword(s):  
Placebo Group ◽  
Venous Drainage ◽  
Controlled Study ◽  
Simple Method ◽  
Mild Pain ◽  
Number Of Patients ◽  
Calculated Dose ◽  
American Society ◽  
Double Blinded ◽  
American Society Of Anesthesiologists

Introductions: Propofol is a popular intravenous anesthetic agent. One disadvantage of propofol is pain on its injection which can be excruciating at times. Various agents and methods have been tried to attenuate this unpleasant effect. Ondansetron, primarily used as an antiemetic has also been studied to reduce it. Methods: This randomized, prospective, double-blinded, placebo-controlled study was conducted on patients of either sex, American Society of Anesthesiologists (ASA) physical status I & II, undergoing elective surgeries requiring general anesthesia. The patients were randomly divided into ondansetron (A, received intravenous ondansetron 4 mg) and placebo (B, received equivalent volume of normal saline) groups. Manual occlusion of venous drainage was done at mid-arm by an assistant for 1 minute after which 25% of the calculated dose (2 mg/kg) of propofol (1% w/v in lipid base) was injected. Patients were asked by a blinded investigator to score the pain on injection of propofol on 4-point scale: 0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain and compared in between two groups. The p<0.05 was considered significant. Results: There were 96 adult patients, 48 in each group of Ondansetron placebo. Pain on propofol injection was found significantly higher in the placebo group compared to the ondansetron group. (62.5% vs 35.4%). Most of the patients in the ondansetron group had mild pain only, whereas, a significant number of patients in the placebo group had higher degrees of pain on propofol injection. Conclusions: Prophylactic intravenous 4 mg ondansetron is a safe and simple method of attenuating pain on propofol injection.

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