Intravenous Dexmedetomidine Administration Prior Anesthesia Induction With Propofol at 4°C Attenuates Propofol Injection Pain: A Double-Blind, Randomized, Placebo-Controlled Trial

Background: Propofol injection pain, despite various interventions, still occurs during the anesthesia induction and causes intense discomfort and anxiety in patients. This study aimed to explore the effect of intravenous dexmedetomidine on propofol injection pain prior to anesthesia induction with propofol at 4°C.Methods: A total of 251 patients (American Society of Anesthesiologists I–II) who underwent oral and maxillofacial surgery were randomly assigned to a combination group (n = 63), lidocaine group (n = 62), dexmedetomidine group (n = 63), and placebo-control group (n = 63); they received 0.5 ug/kg dexmedetomidine prior to anesthesia induction with propofol at 4°C, 40 mg lidocaine, 0.5 ug/kg dexmedetomidine prior to anesthesia induction, and normal saline, respectively. Incidence of pain, pain intensity, and reaction to the pain stimulus were evaluated by using verbal categorial scoring (VCS), a numerical rating scale (NRS), and the Surgical Pleth Index (SPI), respectively. In addition, hemodynamic parameters such as heart rate (HR) and mean arterial pressure (MAP) were also measured. The VCS and NRS were evaluated at 5 s after propofol injection. In addition, SPI, HR, and MAP were evaluated at three time points (before anesthesia induction and 5 and 30 s after propofol injection).Results: The incidence of pain in the combination group (51%) was significantly lower than that in the lidocaine group (71%), dexmedetomidine group (67%), or placebo-control group (94%) (p < 0.001). VCS and NRS scores in the combination group were also lower compared with the other three groups (p < 0.001), with no statistically significant differences between the lidocaine group and dexmedetomidine group (p > 0.05). The SPI of the combination group decreased significantly in comparison with the other three groups at 5 s after propofol injection (F = 96.23, p < 0.001) and 30 s after propofol injection (F = 4.46, p = 0.005). Further comparisons between HR and MAP revealed no significant differences across the groups (p > 0.05).Conclusion: Because of the sedative nature of dexmedetomidine and analgesic effect of low temperature, this study showed that intravenous dexmedetomidine prior to anesthesia induction with propofol at 4°C is highly effective in attenuating the incidence and severity of pain during injection compared with lidocaine (40 mg), dexmedetomidine 0.5 ug/kg) and placebo. This approach was not associated with any anesthesia complications.Clinical Trial Registration:ClinicalTrials.gov, identifier: ChiCTR-2000034663

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Comparative effects of lidocaine and esmolol in attenuating the hemodynamic response to laryngoscopy and intubation

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v17i2.17144 ◽

2017 ◽

Vol 17 (2) ◽

pp. 23-30

Author(s):

Ram Bhakta Koju ◽

Y Dongol

Keyword(s):

Blood Pressure ◽

Placebo Group ◽

Statistical Significance ◽

Hemodynamic Response ◽

Hemodynamic Instability ◽

Control Group ◽

Placebo Control ◽

Lidocaine Group ◽

Placebo Control Group ◽

American Society

Introduction: Transient hemodynamic instability is an inevitable outcome of laryngoscopy and intubation which can have serious effects in patients with COPD, heart disease and hypertension. Hemodynamic stability is one of the main goals of the anesthesiologist. This study was performed to compare the safety and effectiveness of lidocaine and esmolol in comparison to placebo-control group, in modifying the hemodynamic response to laryngoscopy and intubation.Methods: After approval of the study protocol by the institutional review board (IRB), written informed consent was obtained from each patient. It was a randomized placebo-controlled, double-blinded study. 75 patients of American Society of Anesthesiologists physical status I and II, scheduled for general surgery under GA, aged between 20-60 years were randomly allocated into three groups: placebo control group (n=25), lidocaine group (n=25) and esmolol group (n=25). Placebo group received 12 ml normal saline, lidocaine group received 1.5mg/kg lidocaine (total volume 12 ml) and esmolol group received 1.4mg/kg esmolol (total volume 12ml).Results: Following laryngoscopy and intubation, the increase in systolic blood pressure, diastolic blood pressure and heart rate were significantly lower (p < 0.05) in esmolol group compared to the lidocaine and placebo group but there was no statistical significance (p > 0.05) between control and lidocaine group.Conclusion: Esmolol 1.4 mg/kg IV was significantly more effective in controlling the hemodynamic response following laryngoscopy and intubation in comparison to lidocaine 1.5 mg/kg.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 23-30

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Comparison of lidocaine, huffing maneuver and combination of both in prevention fentanyl induced cough before induction of anesthesia: a double-blind, prospective, randomized placebo-controlled study

BMC Anesthesiology ◽

10.1186/s12871-021-01313-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Laleh Dehghanpisheh ◽

Mohammadhossein Eghbal ◽

Fatemeh Bagheri Baravati ◽

Pooya Vatankhah

Keyword(s):

Controlled Trial ◽

Intervention Group ◽

Controlled Study ◽

Control Group ◽

Placebo Control ◽

Anesthesia Induction ◽

Double Blind ◽

Lidocaine Group ◽

Cough Reflex ◽

Significant Difference

Abstract Background Intravenous bolus injection of fentanyl has been frequently reported to be associated with cough reflex during patient anesthesia. However, the search for the most effective protocol continues. This study aimed to compare the effect of reducing cough reflex after injection of fentanyl in a fusion protocol by combining the injections of lidocaine and Huffing maneuver and comparing with a placebo control group, before anesthesia induction. Methods This prospective randomized controlled trial study was performed on 400 patients who were divided into four groups of combined protocol (group 1), lidocaine group (group 2), Huffing maneuver group (group 3), and the control receiving normal saline (group 4). Then patients were injected with 2. 5 μg /kg fentanyl and monitored for 2 min regarding their cough reflex, as well as the severity. Results In group one, 9 patients (9%), in group two, 45 patients (45%), 22 patients (22%) in group three, and in group four, 75 patients (75%), developed cough reflex following fentanyl injection. Also, 13 patients (13%) developed moderate and 4 (4%) developed severe coughs in the control group reported, while no reports of severe or moderate cough were among the intervention groups. There was a significant difference between the intervention group and the control group both in terms of the rate and severity of the fentanyl-induced cough. Conclusion By using a combination of lidocaine injection along and Huffing maneuver, better results can be obtained in reducing the frequency, and also the severity of cough followed by fentanyl injection. Trial registration The trial was registered with IRCT.IR (09/03/2018-No. IRCT20141009019470N74).

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Effect of nalbuphine on rocuronium injection pain

World Journal of Pediatric Surgery ◽

10.1136/wjps-2020-000249 ◽

2021 ◽

Vol 4 (3) ◽

pp. e000249

Author(s):

Wenfang Huang ◽

Jinjin Huang ◽

Dongpi Wang ◽

Yaoqin Hu ◽

Jiangmei Wang ◽

...

Keyword(s):

Respiratory Depression ◽

Intravenous Injection ◽

Adverse Reactions ◽

The Other ◽

Injection Pain ◽

Control Group ◽

Lidocaine Group ◽

Group Control ◽

Group Control Group ◽

Control Group Group

ObjectiveRocuronium-associated intravenous injection pain occurs frequently in children during induction of anesthesia. The aim of this study was to systematically evaluate the benefits of nalbuphine in patients with rocuronium-associated injection pain.MethodsNinety children undergoing tonsillectomy and adenoidectomy in our hospital between October 2019 and September 2020 were randomly divided into the following groups, with 30 patients per group: control group (group C), lidocaine group (group L), and nalbuphine group (group N). Routine 0.1 mg/kg midazolam and 2 mg/kg propofol were injected intravenously. After sedation, children in group C, group L, and group N were administered an intravenous injection of saline, lidocaine (10 mg/mL), or nalbuphine hydrochloride (2 mg/mL), respectively, at a dosage of 0.1 mL/kg. Intravenous injection of rocuronium stock solution (0.6 mg/kg) was administered 2 minutes later. Pain was evaluated using Ambeshs 4-pointscale. The incidence of rocuronium injection pain was compared among the three groups, and postoperative adverse reactions, such as drowsiness, bradycardia, hypotension, and respiratory depression, were evaluated.ResultsThe incidence of injection pain among children in group N was significantly lower than that in group C and group L (p<0.05). The incidence of drowsiness in group N was significantly higher than that in the other groups (p<0.05). The incidences of hypotension, bradycardia, and respiratory depression were not significantly different among the three groups (p>0.05).ConclusionsIntravenous nalbuphine during induction of anesthesia effectively prevented rocuronium-associated injection pain in children. Drowsiness is a complication.

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ESTIMATING EFFECTS OF SYSTEMATIC TREATMENT ON RENAL FAILURE AND DEATH WITHOUT A PARALLEL PLACEBO CONTROL GROUP

Nephrology ◽

10.1046/j.1440-1797.2000.abs122.x ◽

2000 ◽

Vol 5 (3) ◽

pp. A97-A97

Author(s):

Hoy We ◽

Baker P ◽

Wang Z ◽

Cass A ◽

Mathews Jd ◽

...

Keyword(s):

Renal Failure ◽

Control Group ◽

Placebo Control ◽

Systematic Treatment ◽

Placebo Control Group

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Efficacy and Safety of Ejiao (Asini Corii Colla) in Women With Blood Deficient Symptoms: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial

Frontiers in Pharmacology ◽

10.3389/fphar.2021.718154 ◽

2021 ◽

Vol 12 ◽

Author(s):

Li Zhang ◽

Zhongju Xu ◽

Tao Jiang ◽

Jialu Zhang ◽

Pinxian Huang ◽

...

Keyword(s):

Chinese Medicine ◽

Traditional Chinese Medicine ◽

Blood Cell ◽

Control Group ◽

Placebo Control ◽

Controlled Clinical Trial ◽

Efficacy And Safety ◽

Double Blind ◽

Placebo Control Group ◽

Sf 36

Equus asinus L [Equidae; Asini Corii Colla] (donkey-hide gelatin, Ejiao), a well-known traditional Chinese medicine, has been widely used to nourish the blood, especially for women. The aim of this study was to assess the efficacy and safety of Ejiao in blood-deficient patients. A total of 210 participants were recruited and randomly allocated into the placebo control group and Ejiao-treated group (6 g/day). The primary outcomes on the efficacy of Ejiao included traditional Chinese medicine symptom scores, blood indicators, and SF-36. The secondary outcomes were changes in fireness and safety evaluation. Results showed that Ejiao treatment for 8 weeks had significantly improved dizziness symptoms. Among the tested 24 blood biochemical parameters, the hematocrit and red blood cell numbers decreased in the placebo control group, but decreased significantly less in the Ejiao treatment group. The white blood cell and neutrophil counts increased in the Ejiao group but were within the normal range. In addition, the quality of life improved as the scores in SF-36 domains were significantly higher in the Ejiao group. At the same time, there was no significant change in the fire–heat symptoms score or other safety parameters. Considering all these, our study showed that Ejiao has a promising effect in women suffering from blood deficiency without obvious adverse effects.

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Sulfinpyrazone And Prevention Of Postoperative Deep Venous Thrombosis(DVT)

10.1055/s-0038-1653220 ◽

1981 ◽

Author(s):

G Arapakis ◽

A Trovas ◽

G Orphanoudakis ◽

P Vassilikos

Keyword(s):

Arterial Thrombosis ◽

Statistical Significance ◽

Group Analysis ◽

Control Group ◽

Placebo Control ◽

Double Blind Trial ◽

Double Blind ◽

Placebo Control Group ◽

Postoperative Deep Venous Thrombosis ◽

Surgical Operations

Though the antithrombotic properties of sulfinpyrazone (SP) in arterial thrombosis have been documented, its value in phlebothrombosis remains uncertain. In this randomized double-blind trial, the effect of SP (500mg I.M. twice daily for the first 10 postoperative days) on postoperative DVT was compared with a placebo control group. 96 (65 male and 31 female) patients 41 to 83 years of age undergoing major surgical operations were included in the trial. The composition of the two groups (treated and placebo) were homogenious regarding age, sex and type of operation (0,30<p<0,50). The incidence of DVT was estimated clinically and isotopically by the 125I-labelled figrinogen test.No clinical phlebothrombosis was observed in either group but DVT was detected isotopically in 4 (8,3%) out of 48 in the placebo and in 7 (14,5%) of the 48 in the SP group. Analysis by the x2 showed no statistical significance in the prevalence of postoperative DVT between the two groups (x2<x20,30/1). These results suggest that SP has no place in the prevention of postoperative DVT.

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Improving mental health and physiological stress responses in mothers following traumatic childbirth and in their infants: study protocol for the Swiss TrAumatic biRth Trial (START)

BMJ Open ◽

10.1136/bmjopen-2019-032469 ◽

2019 ◽

Vol 9 (12) ◽

pp. e032469 ◽

Cited By ~ 1

Author(s):

Vania Sandoz ◽

Camille Deforges ◽

Suzannah Stuijfzand ◽

Manuella Epiney ◽

Yvan Vial ◽

...

Keyword(s):

Infant Development ◽

Primary Outcome ◽

Physiological Stress ◽

Control Group ◽

Placebo Control ◽

Ptsd Symptoms ◽

Intrusive Memories ◽

Placebo Control Group ◽

Psychological Vulnerability ◽

Traumatic Childbirth

IntroductionEmergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother–infant interactions, but also on long-term infant development. The partner’s mental health may also affect infant development. Evidence-based early interventions to prevent the development of postpartum PTSD in mothers are lacking. Immediately after a traumatic event, memory formation is vulnerable to interference. There is accumulating evidence that a brief behavioural intervention including a visuospatial task may result in a reduction in intrusive memories of the trauma.Methods and analysisThis study protocol describes a double-blind multicentre randomised controlled phase III trial testing an early brief maternal intervention including the computer game ‘Tetris’ on intrusive memories of the ECS trauma (≤1 week) and PTSD symptoms (6 weeks, primary outcome) of 144 women following an ECS. The intervention group will carry out a brief behavioural procedure including playing Tetris. The attention-placebo control group will complete a brief written activity log. Both simple cognitive tasks will be completed within the first 6 hours following traumatic childbirth. The intervention is delivered by midwives/nurses in the maternity unit.The primary outcome will be differences in the presence and severity of maternal PTSD symptoms between the intervention and the attention-placebo control group at 6 weeks post partum. Secondary outcomes will be physiological stress and psychological vulnerability, mother–infant interaction and infant developmental outcomes. Other outcomes will be psychological vulnerability and physiological regulation of the partner and their bonding with the infant, as well as the number of intrusive memories of the event.Ethics and disseminationEthical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2017–02142). Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media.Trial registration numberNCT 03576586.

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Alcohol and Aggression

Psychological Science ◽

10.1111/j.1467-9280.2007.01953.x ◽

2007 ◽

Vol 18 (7) ◽

pp. 649-655 ◽

Cited By ~ 48

Author(s):

Peter R. Giancola ◽

Michelle D. Corman

Keyword(s):

Working Memory ◽

Attention Allocation ◽

Control Group ◽

Placebo Control ◽

Sequential Order ◽

Allocation Model ◽

Placebo Control Group ◽

Electric Shocks ◽

Moderate Load ◽

Laboratory Task

This article presents the first systematic test of the attention-allocation model for alcohol-related aggression. According to this model, alcohol has a “myopic” effect on attentional capacity that presumably facilitates aggression by focusing attention on more salient provocative, rather than less salient inhibitory, cues in hostile situations. Aggression was assessed using a laboratory task in which mild electric shocks were received from, and administered to, a fictitious opponent. Study 1 demonstrated that a moderate-load cognitive distractor suppressed aggression in intoxicated subjects (to levels even lower than those exhibited by a placebo control group). Study 2 assessed how varying the magnitude of a distracting cognitive load affected aggression in the alcohol and placebo conditions. Results indicated that the moderate-load distraction used in Study 1 (i.e., holding four elements in sequential order in working memory) suppressed aggression best. Cognitive loads of larger and smaller magnitudes were not successful in attenuating aggression.

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Physical Activity and Cognitive Performance in the Older Population

Journal of Aging and Physical Activity ◽

10.1123/japa.3.2.135 ◽

1995 ◽

Vol 3 (2) ◽

pp. 135-145 ◽

Cited By ~ 35

Author(s):

Jamie L. Moul ◽

Bert Goldman ◽

Beverly Warren

Keyword(s):

Cognitive Performance ◽

Weight Training ◽

Training Group ◽

Knee Extensors ◽

Control Group ◽

Placebo Control ◽

Older Population ◽

Strength Assessment ◽

Placebo Control Group ◽

Walking Group

The effect of exercise on cognitive performance in an older population was studied. Thirty sedentary men and women 65–72 years of age were randomly assigned to a walking group, a weight training group, or a placebo control group. Intervention groups exercised 30–60 min 5 days per week for 16 weeks, with the walking group training at 60% heart rate reserve, the weight training group employing the DAPRE method of weight progression, and the placebo control group engaging in mild range-of-motion and flexibility movements that kept their heart rates close to resting levels. At baseline and 16 weeks posttraining each subject completed the Ross Information Processing Assessment (RIPA), a maximal graded treadmill test, and a strength assessment of the knee extensors and elbow flexors. Sixteen weeks of walking improved VO2peak of the sedentary subjects 15.8%; VO2peak did not improve in the other two groups. Additionally, the RIPA scores of the walking group increased 7.5%, while those of the weight-training and control groups showed little change.

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Effectiveness of Dentist-Prescribed, Home-Applied Tooth Whitening, A Meta-analysis

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-1-4-34 ◽

1999 ◽

Vol 1 (4) ◽

pp. 34-49 ◽

Cited By ~ 11

Author(s):

Richard Niederman ◽

Maggie C. Tantraphol ◽

Patricia Slnin ◽

Catherine Hayes ◽

Suzy Conway

Keyword(s):

Clinical Trials ◽

Meta Analysis ◽

Control Group ◽

Placebo Control ◽

List Type ◽

Tooth Whitening ◽

Clinical Applicability ◽

Placebo Control Group ◽

The People ◽

Shade Guide

Abstract Introduction Common clinical experience suggests that tooth whitening agents are 100% effective. This study uses meta-analysis of data from published randomized controlled clinical trials to determine the efficacy of tooth whitening agents. Methods A MEDLINE search strategy was developed and implemented to systematically identify clinical trials on dentist-prescribed, home-applied tooth whitening agents, using 10% carbamide peroxide, published between 1989-1999. Inclusion criteria (e.g., in English, human clinical trials) and exclusion criteria (e.g., not placebo controlled) were established and clinical trials that met these criteria were critically appraised for validity and clinical applicability. Meta-analysis was then used to quantitatively integrate the findings. Results Seven studies were identified that met the inclusion and validity criteria. These studies indicated that: Whitening results in a significant mean change of 6 4 shade guide units (p < 0.01), while the placebo control group exhibited little change (0.7 0.6, p > 0.05). 93% of the bleached patients exhibited 2 shade guide unit change, while 20% of the placebo control group exhibited this change. The brand of bleaching agent had a significant effect on tooth whitening, but the daily application time and duration of treatment did not. Whitening is maintained for 6 months for 1/2 of the people treated. Neither gingival indices nor plaque indices were adversely or favorably affected by bleaching. Clinical Applicability The data from the reviewed studies indicate that rather than being 100% effective, on average: 73% (93% for bleached group minus 20% placebo group) of people who whiten their teeth will exhibit a whitening that is 2 shade guide units greater than the placebo. 20% of the people who use dentist-prescribed, home-applied bleaching will achieve a mean whitening effect of 5 shade guide units. Re-treatment for 50% of people may be necessary to maintain this effect longer than 6 months. The methods used here are Internet applicable for other clinical topics.

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