scholarly journals The Effect of Gamification through a Virtual Reality on Preoperative Anxiety in Pediatric Patients Undergoing General Anesthesia: A Prospective, Randomized, and Controlled Trial

2018 ◽  
Vol 7 (9) ◽  
pp. 284 ◽  
Author(s):  
Jung-Hee Ryu ◽  
Jin-Woo Park ◽  
Francis Nahm ◽  
Young-Tae Jeon ◽  
Ah-Young Oh ◽  
...  
Keyword(s):  
Virtual Reality ◽  
General Anesthesia ◽  
Rating Scale ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Final Analysis ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Behavior Rating Scale ◽  
Anxiety Induction

The use of gamification in healthcare has been gaining popularity. This prospective, randomized, clinical trial was designed to evaluate whether gamification of the preoperative process—via virtual reality (VR) gaming that provides a vivid, immersive and realistic experience—could reduce preoperative anxiety in children. Seventy children scheduled for elective surgery under general anesthesia were randomly divided into either the control or gamification group. Children in the control group received conventional education regarding the preoperative process, whereas those in the gamification group played a 5 min VR game experiencing the preoperative experience. Preoperative anxiety, induction compliance checklist (ICC), and procedural behavior rating scale (PBRS) were measured. Sixty-nine children were included in the final analysis (control group = 35, gamification = 34). Preoperative anxiety (28.3 [23.3–36.7] vs. 46.7 [31.7–51.7]; p < 0.001) and intraoperative compliance measured using ICC (p = 0.038) were lower in the gamification group than in the control group. However, PBRS (p = 0.092) and parent/guardian satisfaction (p = 0.268) were comparable between the two groups. VR experience of the preoperative process could reduce preoperative anxiety and improve compliance during anesthetic induction in children undergoing elective surgery and general anesthesia.

scholarly journals Effect of Low-Dose (Single-Dose) Magnesium Sulfate on Postoperative Analgesia in Hysterectomy Patients Receiving Balanced General Anesthesia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Arman Taheri ◽  
Katayoun Haryalchi ◽  
Mandana Mansour Ghanaie ◽  
Neda Habibi Arejan
Keyword(s):  
Single Dose ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Magnesium Sulfate ◽  
Pain Score ◽  
Normal Saline ◽  
Low Dose ◽  
Rating Scale ◽  
Controlled Trial ◽  
Control Group

Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of single low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH) pain relief under balanced general anesthesia.Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N=20) and normal saline (N=20) groups randomly. The magnesium group received magnesium sulfate 50 mg·kg−1in 100 mL of normal saline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100 mL of 0.9% sodium chloride solution at the same time. The same balanced general anesthesia was induced for two groups. Pethidine consumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale (NRS) at 0, 6, 12, and 24 hours after the surgeries.Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24 hours after the operations significantly (P<0.05).Pethidinerequirement was significantly lower in magnesium group throughout 24 hours after the surgeries (P=0.0001).Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could be considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH.

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals Application of Virtual Reality on Non-drug Behavioral Management of Short-term Dental Procedure in Children

2021 ◽  
Author(s):  
Longkuan Ran ◽  
Nan Zhao ◽  
Lin Fan ◽  
Pinping Zhou ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Virtual Reality ◽  
Behavior Management ◽  
Rating Scale ◽  
Treatment Time ◽  
Control Group ◽  
Behavioral Management ◽  
Dental Procedure ◽  
Short Term ◽  
Behavior Rating Scale

Abstract Backgroud: The inherent characteristics of immersion, imagination, and interactivity in Virtual Reality,it may be suitable for non-drug behavior management of children in dental clinics.The purpose of this trial was to measure the role of virtual reality distraction on the behavior management of short-term dental procedure in Children.Methods: A randomized clinical trial design carried out on 120 children aged between 4 and 8 years to make clear the comparative efficacy of virtual reality and Tell-Show-Do in improve behavioral management of dental procedure.The levels of operative anxiety and pain were assessed using, respectively, Children’s Fear Survey Schedule-Dental Subscale, Visual Analogue Score. Frankl Behavior Rating Scale was tested before and during dental procedure.The length of dental procedure was compared between the two groups after treatment.Results: The average anxiety and behavioral score of virtual reality group were significant reduced than that of control. The decrease score of anxiety score of virtual reality group and control group were IQR 8(7,11) and 5(5,7),p <0.05. The compliance scores of control group in the treatment time were 3(2,3),the same in virtual reality intervention were 3(3,4), p =0.02. We observed a significant reduction in pain by using Virtual Reality distraction(p<0.05). Comparing the length of dental procedure, we found that VR group(19.02±5.32) had shorter treatment time than the control group(27.80±10.40)Conclusion: The use of virtual reality could significantly reduce the anxiety and pain of children , length of dental procedure and improve the compliance of children undergoing short-term dental procedure without adverse reaction.Trial registration: Chinese Clinical Trial Registry :ChiCTR2000029802. Registered on 14th Feb, 2020.

scholarly journals Ketorolac tromethamine pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a prospective randomized controlled trial

2020 ◽  
Author(s):  
Zhen Tian ◽  
Bei Hu ◽  
Min Miao ◽  
Lulu Zhang ◽  
Lin Wang ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Recovery Period ◽  
Control Group ◽  
Anesthesia Induction ◽  
Observation Group ◽  
Ketorolac Tromethamine ◽  
Clinical Trial Registry ◽  
Significant Difference

Abstract Background: To observe the effect about pretreatment of ketorolac tromethamine on sufentanil-induced cough in general anesthesia patients. Methods: 102 patients were screened, and a total of 90 patients were scheduled for elective surgery under general anesthesia. 90 patients were randomly divided into two groups: the control group（C group）and the observation group（KT group）. 5 minutes before anesthesia induction, observation group were given ketorolac tromethamine 0.5mg/kg intravenously within 3 s, while the control group were given the same amount of normal saline intravenously. All patients were given a sufentanil bolus of 0.5 ug/kg（within 3 s）intravenously,1 minute later, propofol 2.5mg/kg, vecuronium 0.15mg/kg were injected intravenously, and endotracheal intubation was guided by laryngoscope. The number of coughs that occurred within 1 min after sufentanil injection were recorded. The mean arterial pressure (MAP)，heart rate (HR) and pulse oxygen saturation(SpO2) were recorded at T0 (immediately before pretreatment), T1 (5 minutes after pretreatment), T2（before intubation），T3 (1 min after intubation) and T4 (5 min after intubation).The incidence of adverse reactions were analyzed. Results: Within 1 min after sufentanil injection, the incidence and severity of cough in KT group was significantly lower than that in C group ( P < 0.05). At the time points of T0, T1, T2, T3 and T4, there was no significant difference in MAP, HR and SpO2 between the two groups ( P > 0.05). And there was no significant difference in the dosage of sufentanil, propofol, remifentanil and vecuronium, incidence of nausea and vomiting, delay of recovery, dizziness, drowsiness and respiratory depression between the two groups( P > 0.05). However, there were significant differences in the number of restlessness during waking period ( P < 0.05). Conclusion: Pretreatment of intravenous ketorolac tromethamine can significantly reduce the incidence of sufentanil-induced cough during induction period of general anesthesia patients, and can also significantly reduce the restlessness during recovery period of patients. Trial registration: Chinese Clinical Trial Registry (registration number# ChiCTR2000030287; date of registration: 27/02/2020).

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals Application of virtual reality on non-drug behavioral management of short-term dental procedure in children

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Longkuan Ran ◽  
Nan Zhao ◽  
Lin Fan ◽  
Pinping Zhou ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Virtual Reality ◽  
Behavior Management ◽  
Rating Scale ◽  
Control Group ◽  
Behavioral Management ◽  
Dental Procedure ◽  
Short Term ◽  
Behavior Rating Scale ◽  
Dental Procedures

Abstract Background Due to the inherent characteristics of immersion, imagination, and interactivity in virtual reality (VR), it might be suitable for non-drug behavior management of children in dental clinics. The purpose of this trial was to measure the role of VR distraction on behavior management in short-term dental procedures in children. Methods A randomized clinical trial design was carried out on 120 children aged between 4 and 8 years to identify the comparative efficacy of VR and tell-show-do (TSD) to improve behavioral management during dental procedures. The primary outcomes were evaluated anxiety, pain, and compliance scores in perioperative children. The levels of operative anxiety and pain were assessed using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Wong Baker FACES Pain Rating Scale (WBFS), respectively. The Frankl Behavior Rating Scale (FBRS) was tested before and during dental procedures. The length of the dental procedure was compared between both groups after treatment. Results The average anxiety and behavioral scores of the VR group significantly reduced compared with the control. The decreased anxiety score for the VR group and control group were 8 (7, 11) and 5 (5, 7), p < 0.05. The compliance scores of the control group during treatment were 3 (2, 3), and the same in the VR intervention were 3 (3, 4), p = 0.02. A significant reduction in pain was observed when using VR distraction (p < 0.05). Comparing the length of the dental procedure, the VR group (19.0 2 ± 5.32 min) had a shorter treatment time than the control group (27.80 ± 10.40 min). Conclusion The use of VR significantly reduced the anxiety and pain of children and the length of the dental procedure and improved the compliance of children that underwent short-term dental procedures without an adverse reaction. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029802. Registered on February 14, 2020

scholarly journals A Virtual Reality Video to Improve Information Provision and Reduce Anxiety Before Cesarean Delivery: Randomized Controlled Trial

10.2196/15872 ◽  
2019 ◽  
Vol 6 (12) ◽  
pp. e15872 ◽  
Author(s):  
Lore Noben ◽  
Simone Maria Theresia Anna Goossens ◽  
Sophie Eva Marieke Truijens ◽  
Marijn Marthe Georgine van Berckel ◽  
Christel Wilhelmina Perquin ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cesarean Delivery ◽  
Controlled Trial ◽  
Small Sample ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Birth Experience ◽  
Preoperative Information ◽  
History Of ◽  
Anxiety Levels

Background Anxiety levels before cesarean delivery (CD) can lead to a negative birth experience, which may influence several aspects of the woman’s life in the long term. Improving preoperative information may lower preoperative anxiety and lead to a more positive birth experience. Objective This study aimed to determine whether a virtual reality (VR) video in addition to standard preoperative information decreases anxiety levels before a planned CD. Methods Women scheduled to undergo term elective CD were recruited from the outpatient clinic. They were randomized and stratified based on history of emergency CD (yes or no). All participants received standard preoperative information (folder leaflets and counseling by the obstetrician); the VR group additionally watched the VR video showing all aspects of CD such as the ward admission, operating theater, spinal analgesia, and moment of birth. The primary outcome measure was a change in score on the Visual Analogue Scale for Anxiety (ΔVAS-A) measured at admission for CD, compared with the baseline VAS-A score. Results A total of 97 women were included for analysis. The baseline characteristics were similar in both groups, except for a significantly higher level of education in the control group. There was no significant decrease in the VAS-A score of the women in the VR group (n=49) compared with those in the control group (n=48; ΔVAS-A=1.0; P=.08; 95% CI −0.1 to 2.0). Subgroup analysis for the group of women with a history of emergency CD showed a trend toward decreased preoperative anxiety, despite the small sample size of this subgroup (n=17; P=.06). Of the 26 participants who provided completed questionnaires, 22 (85%) in the VR group reported feeling more prepared after seeing the VR video; of the 24 participants’ partners who completed the questionnaires, 19 (79%) agreed with the participants. No discomfort or motion sickness was reported. Conclusions A VR video may help patients and their partners feel better prepared when planning a CD. This study showed that VR does not lead to a decrease in preoperative anxiety. However, subgroups such as women with a history of emergency CD may benefit from VR videos. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) 74794447; http://www.isrctn.com/ISRCTN74794447 (retrospectively registered)

scholarly journals A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial

2019 ◽  
Author(s):  
Wendong Lin ◽  
Jiehao Sun ◽  
Shuying Fu
Keyword(s):  
General Anesthesia ◽  
Small Dose ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Inhibitory Effect ◽  
Control Group ◽  
Anesthesia Induction ◽  
Double Blind ◽  
Prospective Randomized Controlled Trial ◽  
Size Groups

Abstract Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia. Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded. Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05). Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.

scholarly journals Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Cervical Plexus ◽  
Ethics Review ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

scholarly journals The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Young Eun Moon
Keyword(s):  
General Anesthesia ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Perioperative Period ◽  
Postoperative Outcomes ◽  
Control Group ◽  
Quality Of Recovery ◽  
Gynecological Laparoscopy ◽  
Prospective Randomized Controlled Trial

Abstract Background Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods The participants (n = 78) will be allocated to one of the two groups; the study group will receive bolus and infusion of dexmedetomidine and lidocaine, and the control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in the two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, and opioid-related side effects will be assessed. Additionally, an ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during the study period. Discussion This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA. Trial registration ClinicalTrials.gov NCT04409964. Registered on 28 May 2020

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