Effect of Intravenous Lignocaine in Attenuating Dexamethasone Induced Perineal Pruritus During Induction of Anesthesia

Background: Intravenous dexamethasone may produce perineal pruritus in some patients when administered as premedicant before induction of anesthesia. Objectives of study: This randomized, double-blind study was done to evaluate the efficacy of pretreatment of lignocaine on the incidence and severity of dexamethasone-induced perineal pruritus. Materials and methods: 100 patients were enrolled in this study and allocated randomly into two equal groups. Then, patients received intravenous medications in the following sequence before induction of anesthesia: in group I, injection lignocaine 1mg/kg diluted in 5 ml normal saline and in group II, 5 ml normal saline (placebo group), then one minute later, intravenous dexamethasone sodium phosphate 10 mg was given in all groups in 3 seconds and was observed the patient's response about perineal pruritus. The severity of perineal pruritus was graded based on the visual analog scale (VAS) as none (VAS 0), mild (VAS 1-3), moderate (VAS 4-6), or severe (VAS 7-10), and recorded the incidence and severity of perineal pruritus. Then general anesthesia was induced and continued as usual. Results: In terms of demographic data, the results of this study showed that there was no significant difference between patients in both groups (P>0.05). Overall incidence and severity of perineal pruritus in lignocaine group was significantly less, when compared with placebo group (P<0.05). Conclusion: It can be concluded that pretreatment with 1mg/kg intravenous lignocaine may effectively reduce the incidence and severity of dexamethasone induced perineal pruritus. KYAMC Journal Vol. 9, No.-4, January 2019, Page 144-147

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Efficacy of Calcipotriol 0.005% Ointment for Uremic Xerosis with Pruritus in Chronic Kidney Diseases Undergoing Hemodialysis Patients: Randomized Double Blind Clinical Trial

BioScientia Medicina ◽

10.32539/bsm.v5i6.319 ◽

2021 ◽

Vol 5 (6) ◽

pp. 531-539

Author(s):

Widyastuti ◽

Yulia Farida Yahya ◽

Suroso Adi Nugroho ◽

Soenarto Kartowigno ◽

M. Izazi Hari Purwoko ◽

...

Keyword(s):

Adverse Effect ◽

Placebo Group ◽

Visual Analog Scale ◽

Kidney Diseases ◽

Double Blind Study ◽

Surface Lipid ◽

Dry Skin ◽

Analog Scale ◽

Double Blind ◽

Skin Score

Introduction: Uremic xerosis with pruritus (UXP) is a chronic cutaneous complication among patients undergoing maintenance renal dialysis. Uremic xerosis level is directly related with pruritus severity or vice versa. Uremic xerosis with pruritus may lead to discomfort and negative psychological effect. The ethiopathogenesis still unknown, Most of treatments are empirical, and there is no effective and safe therapy. Emollient has not been effective enough to improve quality of life. There is some report about efficacy of topical vitamin D in xerosis and chronic pruritus. Objective: We evaluate the efficacy of calcipotriol 0.005% ointment for uremic xerosis and uremic pruritus in chronic kidney disease patients undergoing hemodialysis. Material & methode: Sixty two patients with UXP were enrolled, randomized double blind study. Patients were divided to two group, calcipotriol 0.005% ointment group or placebo. In baseline, patients were instructed to apply twice daily for four weeks. We assesesment the efficacy and safety of calcipotriol 0.005% ointment and placebo after 2nd and 4th weeks treatment using overall dry skin score (ODSS), visual analog scale (VAS), corneometer and sebumeter. We also assessed adverse effect and tolerance this drugs using visual assessment scale. Results: Overall dry skin score (ODSS) and visual analog scale (VAS) significantly decreased in calcipotriol 0.005% ointment group than in placebo group (p <0.05). Skin hydration level based on Corneometer score and skin surface lipid based on Sebumeter score was significantly increased in calcipotriol 0.005% ointment group than in placebo group (p <0.05). Cure rate and clinical improvement for calcipotriol 0.005% ointment group was significantly higher than placebo group. There was no adverse effect between two groups after treatment. Conclusion: calcipotriol 0.005% ointment is effective than placebo and can be used as alternative or adjuctive treatment and safe and tolerance for UXP.

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Pyridoxine is not effective for the prevention of hand foot syndrome (HFS) associated with capecitabine therapy: Results of a randomized double-blind placebo-controlled study

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.9007 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 9007-9007 ◽

Cited By ~ 4

Author(s):

S. Lee ◽

Y. Chun ◽

M. Kim ◽

H. Chang ◽

...

Keyword(s):

Placebo Group ◽

Chemotherapy Regimen ◽

Controlled Study ◽

Double Blind Study ◽

Double Blind ◽

Significant Difference ◽

Hand Foot Syndrome ◽

Version 2.0 ◽

The Mean ◽

To Receive

9007 Introduction: Although pyridoxine has been used empirically for the prevention of HFS associated with capecitabine, its efficacy has not been proven yet. We performed a prospective randomized double-blind study to determine whether pyridoxine can prevent the development of HFS when given concurrently with capecitabine. Method: Chemotherapy-naive patients (pts) with gastrointestinal tract cancers who were going to have capecitabine-containing chemotherapy were randomized to receive either oral pyridoxine (200 mg/day) or placebo daily during chemotherapy after stratified by chemotherapy regimen: 1) capecitabine alone, 2) capecitabine and cisplatin, or 3) docetaxel, capecitabine, and cisplatin. The patients were observed until grade 2 or 3 HFS (by NCI CTC version 2.0) developed or capecitabine containing chemotherapy ended. When grade 2 or 3 HFS developed in pts in placebo group, the pts were randomized again to receive either pyridoxine or placebo for next cycle of chemotherapy in order to determine whether pyridoxine could improve the HFS. Result: From Jun 2004 to Oct 2005, total 389 pts were entered onto the study. But, 29 pts (15 in placebo group and 14 in pyridoxine group) were excluded from the study because of ineligibility or pts’ refusal. Pts’ characteristics were well balanced between the 2 groups. Grade 2 or 3 HFS developed in 55 of 180 (30.6%) pts in placebo group and in 57 of 180 (31.7%) pts in pyridoxine group. (p=0.788) The median cycles of chemotherapy to grade 2 or 3 HFS was 3 in both groups. The mean cumulative dose of capecitabine until occurrence of grade 2 or 3 HFS was not different statistically between the two groups. (221,157.5 mg/m2 vs. 259,808.5 mg/m2, p=0.788). Total 44 of 55 pts in placebo group who had grade 2 or 3 HFS were randomized to receive either placebo or pyridoxine at next cycle. There was no significant difference between the two groups in the proportion of pts with improvement of HFS (43% vs 48%, p=0.94). Conclusion: These results indicated that pyridoxine is not effective for the prevention of HFS associated with capecitabine therapy. No significant financial relationships to disclose.

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Effect of Low Dose Ketamine on Propofol Injection Pain: A Double-Blind Clinical Trial

KYAMC Journal ◽

10.3329/kyamcj.v11i2.48423 ◽

2020 ◽

Vol 11 (2) ◽

pp. 96-99

Author(s):

Muhammad Sazzad Hossain ◽

Md Afzalur Rahman ◽

Syed Ariful Islam ◽

Sanzida Munira ◽

Mohammad Iftakhairul Hasan ◽

...

Keyword(s):

General Anesthesia ◽

Normal Saline ◽

Low Dose ◽

Group Versus ◽

Saline Group ◽

Injection Pain ◽

Double Blind ◽

Group I ◽

Double Blind Clinical Trial ◽

Elective Surgical Procedure

Background: Propofol, most frequently used intravenous anesthetic for induction of routine elective surgical procedure. Pain on propofol injection (POPI) still remains a considerable concern for the anesthesiologist. A number of techniques has been tried to minimize propofol-induced pain with variable results. Objective: This study was performed to determine the effect of ketamine on reducing pain on propofol injection (POPI) at the onset of anesthesia. Materials and Methods: A total of 80 adult healthy patients were selected in this study of either sex, scheduled for routine elective ENT surgery under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I (ketamine group) received 10 mg intravenous ketamine in 10 ml normal saline. Group II (placebo group) received 10 ml of 0.9% intravenous normal saline. Then the patients were induced with propofol and asked to report their pain during injection of propofol and recorded according to the Mc Cririck and Hunter scale. Results: The incidence of pain experienced in ketamine group was 10% patients and in saline group was 60% patients, which is statistically significant p<0.05. The severity of POPI was also lower in ketamine group than the saline group (p<0.05). The incidence of mild and moderate pain in ketamine group versus saline group was 7.5% versus 45% and 2.5% versus 15% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion:Intravenous ketamine in low dose before induction of general anesthesia can be effective medication in reducing pain on propofol injection. KYAMC Journal Vol. 11, No.-2, July 2020, Page 96-99

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Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension

QJM ◽

10.1093/qjmed/hcab086.035 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Saeed Mohamed Ibrahim ◽

Rania Mahrous Aly Hussien ◽

Hazem Mohamed Sabry Abdel Aziz Ahmed

Keyword(s):

Spinal Anesthesia ◽

Local Anesthetic ◽

Normal Saline ◽

Demographic Data ◽

Randomized Study ◽

P Value ◽

Anthropometric Measures ◽

Double Blind ◽

Induced Hypotension ◽

Significant Difference

Abstract Background Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways. Objectives The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries. Patients and Methods Therefore, A prospective double-blind, placebo-controlled, randomized study was found to be the most suitable design in order to achieve the study objectives. A total of 90 patients males & females included in the study, aged 20-40 years, and were divided equally into two groups: Group A received 8 mg ondansetron diluted in volume of 10 cm normal saline 5 minutes prior to spinal anesthesia. Group B received a placebo of 10 cm normal saline 5 minutes prior to spinal anesthesia. Results There was no statistically significant difference found between the two studied groups regarding demographic data, anthropometric measures, ASA score and total time of surgery. There was statistically significant increase in the incidence of hypotension immediately after spinal and at 5 min in placebo group than ondansetron group with p-value = 0.026 and 0.014 respectively. Conclusion The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine for elective for surgeries below umbilicus, prophylactic intravenous ondansetron 8mg iv 5 mins prior to spinal anesthesia reduced spinal anesthesia induced hypotension decreases in SBP, MAP, and heart rate. Ondansetron did not have a significant effect on DBP. Ondansetron did not have a significant effect on DBP. The incidence of nausea and vomiting was lower following the administration of ondansetron, and vasopressor use and dosages were reduced.

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Sodium Citrate: An Alternative Antacid for Prophylaxis against Aspiration Pneumonitis

Anaesthesia and Intensive Care ◽

10.1177/0310057x8201000204 ◽

1982 ◽

Vol 10 (2) ◽

pp. 116-119 ◽

Cited By ~ 12

Author(s):

J. Wrobel ◽

T. C. Koh ◽

J. M. Saunders

Keyword(s):

Placebo Group ◽

Surgical Procedures ◽

Sodium Citrate ◽

Gastric Ph ◽

Double Blind Study ◽

Double Blind ◽

Significant Difference ◽

Gastric Contents ◽

The Mean ◽

Induction Of Anaesthesia

In a double-blind study, 107 patients undergoing elective and emergency surgical procedures were given 15 ml of either sodium citrate 0ṁ3 M or placebo 10 minutes before induction of anaesthesia. Gastric contents were sampled immediately after induction and the pH was measured. The mean pH of the gastric contents of patients given sodium citrate was 5ṁ67, whereas for those given the placebo it was 3ṁ21 (p < 0ṁ001). Of patients given sodium citrate 92% had a gastric pH above 3ṁ0 compared with only 37% in the placebo group (p < 0ṁ001). At the end of surgery gastric contents were emptied as completely as possible and the volume and pH measured. There was no significant difference in the mean volume of gastric contents in the two groups. In neither group was the mean pH at the end of surgery significantly different from that after induction.

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Oral Flurbiprofen Spray for Posttonsillectomy Pain

Otolaryngology ◽

10.1177/0194599816637865 ◽

2016 ◽

Vol 155 (1) ◽

pp. 166-172 ◽

Cited By ~ 6

Author(s):

Togay Muderris ◽

Fatih Gul ◽

Gokhan Yalciner ◽

Mehmet Ali Babademez ◽

Sami Bercin ◽

...

Keyword(s):

Placebo Group ◽

Rating Scale ◽

Demographic Data ◽

Double Blind ◽

Pain Scores ◽

Significant Difference ◽

Lower Pain ◽

Numeric Pain Rating Scale ◽

Rating Scale Data ◽

Posttonsillectomy Pain

Objective Tonsillectomy is still one of the most common surgical procedures, but there exists no standard guideline for pain management after tonsillectomy. Our aim is to determine whether oral spray of flurbiprofen reduces pain and has an influence on other morbid outcomes following tonsillectomy. Study Design Prospective, double-blind, randomized, placebo controlled. Setting Patients at Ataturk Training and Research Hospital, Ankara, Turkey. Subjects and Methods This study was performed on 84 patients (45 in flurbiprofen group, 39 in placebo group) who underwent tonsillectomy. The patients were randomly chosen, and each used oral spray of flurbiprofen 3 times daily or placebo solution at the same regimen. Efficacy was assessed by changes in Numeric Pain Rating Scale. Data were collected at postoperative days 1, 3, 5, and 7 for pain, bleeding, and healing. Data for Mallampati scores were also collected. Results There were no significant difference between groups with respect to the demographic data. The flurbiprofen group had statistically significant lower pain scores at days 1, 3, 5, and 7 ( P = .000, P = .002, P = .001, P = .000, respectively). On days 3 and 7, pain scores were significantly different between different Mallampati groups ( P = .049, P = .015, respectively). The flurbiprofen group required less analgesic than the placebo group during the study period on days 1, 3, 5, and 7 ( P = .001, P = .001, P = .03, P = .001, respectively). Healing and side effects were not significantly different between the groups. Conclusion In this study, topical use of flurbiprofen may reduce posttonsillectomy pain without any evidence of additional complications.

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Comparison of Hemodynamic Changes Due to Endotracheal Intubation With Labetalol and Remifentanil in Severe Preeclamptic Patients Undergoing Cesarean Delivery With General Anesthesia

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2019.85 ◽

2018 ◽

Vol 7 (4) ◽

pp. 515-519 ◽

Cited By ~ 1

Author(s):

Susan Rasooli ◽

Farnaz Moslemi ◽

Reyhaneh Ari ◽

Hale Vazife Shenas ◽

Majid Shokoohi

Keyword(s):

General Anesthesia ◽

Cesarean Delivery ◽

Severe Preeclampsia ◽

Double Blind Study ◽

Double Blind ◽

Apgar Scores ◽

Mortality And Morbidity ◽

Hemodynamic Variables ◽

Increased Risk ◽

Significant Difference

Objectives: Stress replication to laryngoscopy and intubation are exaggerated in the patient with severe preeclampsia and this stress can lead to an increased risk of maternal mortality and morbidity. The aim of this study was to compare the efficacies of remifentanil and labetalol in attenuating these responses in women with violent preeclampsia undergoing cesarean section (C-section) with general anesthesia. Methods: In this double-blind study, 70 women with violent preeclampsia undergoing cesarean delivery were randomly assigned to two groups to receive either remifentanil 1 µg/kg or labetalol 0.25 mg/kg before the induction of anesthesia. Then, blood pressure (BP) and heart rate (HR) were measured before and 1, 3, and 5 minutes after the intubation. The first and 5th-minute Apgar scores were evaluated as well. Results: All hemodynamic variables decreased in both groups after the administration of remifentanil or labetalol. Labetalol significantly attenuated the rise in BP and HR during laryngoscopy and intubation compared to remifentanil (P<0.001). Eventually, no significant difference was found between the Apgar scores of the two groups (P=0.97 and P=0.19, respectively). Conclusion: Overall, the administration of labetalol before the inspiration of anesthesia can control stress replication to laryngoscopy and shows better intubation and more stability than remifentanil in patients with severe preeclampsia undergoing C-section.

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SUBCUTANEOUS ENOXAPARINE (LOVENOXR) VERSUS PLACEBO FOR PREVENTING DEEP VEIN THROMBOSIS (DVT) AFTER TRANSURETHRAL PROSTATECTOMY (TUP)

10.1055/s-0038-1643212 ◽

1987 ◽

Cited By ~ 1

Author(s):

F LE GAGNEUX ◽

A STEG ◽

M LE GUILLOU

Keyword(s):

Placebo Group ◽

Low Molecular Weight ◽

High Dose ◽

Double Blind Study ◽

Red Cell ◽

Transurethral Prostatectomy ◽

Double Blind ◽

Vein Thrombosis ◽

Significant Difference ◽

Deep Vein

The aim of this study was mainly to evaluate the risk of bleeding, and the efficiency of Enoxaparine, a low-molecular-weight-heparin, in preventing DVT in patients undergoing TUP.89 patients (mean age : 67.5 years + 1.3), undergoing TUP, were included in a randomized, double blind study. Patients with a major risk of thromboembolism were excluded. 44 patients received one daily subcutaneous (SC) injection of 60 mg of Enoxaparine ; 45 patients received placebo. All the patients received the first injection 12 hours before operation.Red cell transfusions requirements were not significantly different between the two groups : 18 % of patients in the Enoxaparine group and 13 % of patients in the placebo group received red cell transfusions (p = 0.57). The amount of red cell units required was 3.3 units ± 0.9 in the Enoxaparine group and 2.5 U ± 0.8 in the placebo group (p = 0.51). The urethral catheters were removed on the 4th post operative day in each group.There was no significant difference in daily hemoglobin levels between the two groups.No DVT occurred : 125I fibrinogen scanning was negative in all patients but two : in these two patients (one in each group), DVT was not confirmed by a radiographic phlebography. No pulmonary embolism occurred.Enoxaparine, begun 12 hours before operation, however injected at high dose (60 mg/24 hrs), is safe in patients undergoing TUP. No significant bleeding complication occurred in the Enoxaparine group comparing with the placebo group. Red cell transfusions requirements were the same in both groups. There was no DVT in our patients.Enoxaparine (LOVENOXR) - PHARMUKA S.F.

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The Effect of Silicol Gel Compared with Placebo on Papulopustular Acne and Sebum Production. A Double-Blind Study

Journal of International Medical Research ◽

10.1177/030006059602400404 ◽

1996 ◽

Vol 24 (4) ◽

pp. 340-344 ◽

Cited By ~ 4

Author(s):

A Lassus

Keyword(s):

Placebo Group ◽

Treated Group ◽

Double Blind Study ◽

Concomitant Treatment ◽

Double Blind ◽

Area 5 ◽

Significant Difference ◽

The Face ◽

Sebum Production ◽

The Mean

Altogether 30 patients (19 females and 11 males), mean age 19 years, were divided randomly into two groups. All patients had chronic papulopustular acne of the face. A total of 15 patients were treated topically with Silicol gel for 20 min twice daily for 6 weeks and the remaining 15 patients were treated with a placebo gel in a similar fashion. A clinical evaluation was carried out at baseline, and after 2, 4 and 6 weeks of treatment. The clinical variables evaluated were as follows: number of comedones, papules, pustules and cysts on a standard area of the left cheek (area 5 × 5 cm) and measurement of sebum production on the same area by the use of Sebumeter SM 810 PC (Courage and Khazaka, Ltd, Germany). No concomitant treatment was allowed during the study period. One patient using Silicol gel withdrew after 2 weeks of treatment because of severe irritation of the facial skin, leaving 29 patients who could be evaluated. In the active group, the number of comedones decreased from a mean of 48.5 to 15.1 after 6 weeks of treatment. The corresponding figures for papules were 10.7 and 1.0, for pustules 6.8 and 0, and for cysts 0.6 and 0. In the placebo group no improvement could be observed. There was a highly significant difference in efficacy between the two groups ( P < 0.001) in favour of the actively treated group. The mean sebum index was 193 at baseline and 88 after 6 weeks. Correspondingly, in the placebo group the mean sebum index at baseline was 187 and after 6 weeks 179. This difference between the two groups was also statistically significant ( P < 0.001). After a short follow-up period (3 months) no deterioration was observed in the 14 ‘active’ patients, showing either complete cure or improvement.

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