EFFICACY OF CAUDAL BLOCK WITH LEVOBUPIVACAINE FOR POSTOPERATIVE ANALGESIA AFTER THE SUBUMBILICAL SURGERY IN CHILDREN

2018 ◽  
Vol 8 (5) ◽  
pp. 58-64
Author(s):  
Nga Bui Thi Thuy ◽  
Minh Nguyen Van
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Laryngeal Mask ◽  
Control Group ◽  
Caudal Block ◽  
Cross Sectional ◽  
Relieve Pain ◽  
Group 2 ◽  
Effective Analgesia ◽  
Group 1

Objectives: To evaluate the efficacy of postoperative analgesia, side effects and complications of caudal block with levobupivacaine 0.25% 1mL/kg for subumbilical surgery. Materials and methods: In a comparative cross-sectional descriptive study, sixty ASA I–II children less than 6 years old scheduled for elective subumbilical surgery were randomized to divide into 2 groups: group 1 (control group) were only used general anethesia with laryngeal mask, group 2 (levo group) were anesthetized under general anaesthesia with laryngeal mask and caudal block with levobupivacaine 0.25% 1mL/kg to relieve pain after surgery. The evaluation variables included the duration of postoperative analgesia, total analgesic used in 12 hours after surgery, FLACC score, Ramsay and Bromage score after extubation of laryngeal mask, side effects and complications. Results: The duration of postoperative analgesia in the caudal block group was 8.25 ± 1.48 hours, in the control group was 0.07 ± 0.37 hours. The total dose of acetaminophen and morphine after surgery in the control group were 574.50 mg ± 23.61mg and 3.94 ± 1.6 mg, while in the levo group were 251.25 mg ± 15.7 mg and 0 mg. In the levo group, at the recovery time, all patients had FLACC score ≤ 3 and most of the patients were co-operative and alert. No side effects occurred between two groups. Conclusion: caudal block for postoperative analgesia was a safe and effective analgesia technique for children. Key words: caudal block, levobupivacaine, subumbilical surgery, children, postoperative analgesia

scholarly journals Pre-teens, Audio Analgesia and Dental Care: A Cross-Sectional Study

2020 ◽  
Vol 4 (4) ◽  
pp. 98-101
Author(s):  
Akshaye Kumar ◽  
Priyanka Sharma ◽  
Arjun Malhotra
Keyword(s):  
Cross Sectional Study ◽  
Pain Tolerance ◽  
Control Group ◽  
Cross Sectional ◽  
Pearson’S Correlation ◽  
Promising Alternative ◽  
Pearson's Correlation ◽  
Group 2 ◽  
Fear And Anxiety ◽  
Group 1

INTRODUCTION: Research has proven that music plays an important role in alleviating fear and anxiety among patients.AIM: To assess the effect of audio analgesia in pre-teen children aged 8-12 years undergoing dental restorations. MATERIALS AND METHOD: Data was collected using a pre-tested and pre-validated proforma filled by the child prior to start of the treatment by circling the number corresponding to the expected pain during the procedure [Ranged 0 (No pain) -10 (Maximum pain)]. Children who reported their expected pain above 5, were enrolled in group 1 (The ones receiving audio analgesia) while the remaining were assigned group 2 (controls). Children in group 1 were asked to put on their favourite song using noise cancellation headphones and the procedure was commenced. After completion of the treatment, the VAS scale was re-introduced and the children were asked to re-circle the actual pain experienced during the procedure. Data was analyzed using SPSS version 20.0 using the chi-squared test and Pearson’s correlation coefficient. A significant value was obtained when p was≤ 0.05. RESULTS: Of the total 80 children enrolled in the present study, there were an equal number of males and females (40 each). It was observed that 70.3% of children in group 1 had an increased pain tolerance as compared to only 37.2% of children in the control group(p=0.01). Pearson’s Correlation revealed a positive and linear association (r: +0.721) and a significant relationship (p = 0.03) between both groups. CONCLUSION: Audio analgesia has been proven to a promising alternative to distract the patient from the anxiety faced in the dental setting and is recommended for nervous and anxious patients.

scholarly journals Comparison of the Effects of Adding Dexmedetomidine Versus Midazolam to Intrathecal Bupivacaine on Postoperative Analgesia

2015 ◽  
Vol 18;1 (1;1) ◽  
pp. 71-77
Author(s):  
Aloka Samantaray
Keyword(s):  
Side Effects ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Sedation Score ◽  
Controlled Study ◽  
Saline Control ◽  
Control Group ◽  
Hyperbaric Bupivacaine ◽  
Midazolam Group ◽  
Effective Analgesia

Background: Dexmedetomidine and midazolam both modulate spinal analgesia by different mechanisms, and yet, no human studies are available to compare them for postoperative analgesia after neuraxial administration. Objectives: We investigated the addition of dexmedetomidine or midazolam to intrathecal bupivacaine on the duration of effective analgesia and clinical safety profile. Study Design: Prospective, randomized, double blind, placebo controlled study. Setting: University teaching hospital. Methods: The study cohort included a consecutive and prospective series of patients, referred for endourological procedures. The patients were randomly allocated into 3 groups (20 patients each) to receive intrathecally 3 mL of 0.5% hyperbaric bupivacaine in combination with 5 mcg of dexmedetomidine (dexmedetomidine group), 1 mg of midazolam (midazolam group) or 0.5 mL of 0.9% saline (control group). The groups were compared to the regression time of sensory block, duration of effective analgesia (defined as the time interval between administration of intrathecal drug to the time of first analgesic request or a numeric rating scale ≥ 4.0), sedation score, and side effects in the first 24 hours. Statistics: One way-ANOVA, Kruskal Wallis test, and Chi-square test (χ2), significance level: P < 0.05. Results: The duration of effective analgesia (time to first analgesic request) was significantly prolonged in the dexmedetomidine group (286 ± 64 minutes, P < 0.01) when compared with midazolam group (236.9 ± 64.9 minutes) and the control group (212.7 ± 70.2 minutes). Pairwise comparisons among the 3 groups with Bonferroni adjustment revealed that patients from the dexmedetomidine group were more sedated in comparison to the midazolam and control groups at the end of the first 15 minutes after intrathecal injection [χ2 (2) = 7.157, P = 0.028], with a mean rank sedation score of 35.58 for dexmedetomidine, 25.00 for midazolam, and 30.93 for control. No significant differences in the side effects were observed during the study period. Midazolam did not lengthen the time of the two segment sensory regression or the time to first request analgesia. Limitation: The study cannot be extrapolated to muscle cutting surgeries under spinal anaesthesia. Conclusions: The addition of dexmedetomidine (5 mcg) to 3 mL of intrathecal hyperbaric bupivacaine (0.5%) significantly prolongs the duration of effective analgesia in comparison to 1 mg midazolam or placebo (0.9% normal saline) with a comparable incidences of side effects. Key words: Dexmedetomidine, midazolam, intrathecal, spinal anaesthesia, subarachnoid block, postoperative pain Pain Physician 20

scholarly journals A New Look on Adding Dexamethasone as an Adjuvant to Caudal Bupivacaine; Efficacy on Postoperative Pain and Vomiting in Pediatric Patients

2016 ◽  
Vol 6;19 (6;7) ◽  
pp. E841-E852
Author(s):  
Dr. Sayed Kaoud Abd-Elshafy
Keyword(s):  
Blood Glucose ◽  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Postoperative Vomiting ◽  
Caudal Block ◽  
Dexamethasone Group ◽  
Number Of Patients

Background: Controlling postoperative pain and vomiting in children remains a great challenge. Objective: Study the efficacy of adding dexamethasone to caudal bupivacaine on postoperative analgesia and vomiting. Study Design: Prospective, randomized double blind controlled clinical trial. Setting: Assiut University Hospital. Patients: Ninety children ASA I-II, undergoing lower orthopedic surgeries. Methods: Patients were randomly allocated into 3 equal groups. All received caudal block after induction of anesthesia with 0.5 mL/kg of 0.25% bupivacaine in addition to 5 mL intravenous (IV) normal saline in the control group, IV 0.5 mg/kg dexamethasone in IV dexamethasone group and lastly 0.1 mg/kg dexamethasone in the caudal dexamethasone group. Postoperative pain scores and rescue analgesic consumption were recorded. Blood glucose, postoperative vomiting, and other side effects were evaluated up to 24 hours after extubation. Results: The time of first analgesia and the number of patients requiring rescue analgesics were significantly decreased with intravenous or caudal dexamethasone. No significant increase in postoperative blood glucose levels were observed. A significant increase in β- Endorphin level at 3 and 24 hours postoperative was found in both dexamethasone groups when compared with the preoperative baseline value. The incidence of postoperative vomiting was significantly decreased in both dexamethasone groups in comparison with the control group. No other side effects were detected. Limitations: Measurement of serum cortisol. Conclusion: Analgesic and antiemetic effects of dexamethasone as an adjunct to caudal block with bupivacaine (0.25%) 0.5 mL/kg is similar whether administered intravenously 0.5 mg/kg or caudally 0.1 mg/kg. Key words: B-Endorphin, bupivacaine, caudal, dexamethasone, pediatric, postoperative analgesia, vomiting

scholarly journals Comparative study of efficacy of drotaverine hydrochloride and valethamate bromide with control in first stage of labour

2013 ◽  
Vol 11 (1) ◽  
pp. 38-42 ◽  
Author(s):  
P Dahal ◽  
B Banerjee ◽  
DK Uprety ◽  
BP Das ◽  
A Thakur ◽  
...  
Keyword(s):  
Side Effects ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Fetal Outcome ◽  
Control Group ◽  
P Value ◽  
Drotaverine Hydrochloride ◽  
Group 2 ◽  
And Control ◽  
Group 1

Background: Labour is the most perilous journey a woman has to undertake. Painless and short labour is desired by every woman and is a constant aim for obstetrician.Objective: To analyze and compare the efficacy and safety of drotaverine and valethamate with control group on improving cervical dilatation and promoting progress of labour. Method: Three hundred demographically similar women, both primigravida and multigravida with a term pregnancy in established labour were randomly divided into three groups. One hundred women (group 1) were given injection valethamate intramuscularly,100 women (group 2) were given drotaverine and the rest 100 (group 3) were not given any drug. Comparative analysis was carried out as regards to duration of first stage of labour, mode of delivery, maternal side effects and fetal outcome. Results: The mean duration of active phase of labour in group 1, 2 and 3 was 254.29±96.621 min, 178.31±73.412 min and 346.31±123.351 min respectively. The duration of injection to end of first stage of labour in valethamate and Drotaverine group was 228.12±84.626min and 168.89±69.576min respectively (p value<0.0001). The duration of injection to delivery in Valethamate was 249.13± 88.321 min and in Drotaverine was 192.56±75.479min (p value<0.0001). There were no serious maternal and fetal adverse effects in any group but minor side effects were more common in valethamate group. Conclusion: The reduction of the duration of the first stage of labour was apparently more in drotaverine group as compared to valethamate and control group. Drotaverine was found to be safe with minimal or no adverse effect on the mother and the fetus. Health Renaissance, January-April 2013; Vol. 11 No.1; 38-42 DOI: http://dx.doi.org/10.3126/hren.v11i1.7600

No Enhancement of Sensory and Motor Blockade by Neostigmine Added to Mepivacaine Axillary Plexus Block 

1999 ◽  
Vol 91 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Herve Bouaziz ◽  
Xavier Paqueron ◽  
Marie Lorraine Bur ◽  
Michel Merle ◽  
Marie Claire Laxenaire ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Saline Solution ◽  
Hand Surgery ◽  
Sensory Block ◽  
Group 3 ◽  
Group 2 ◽  
Plexus Block ◽  
Group 1

Background Intrathecal neostigmine induces analgesia but also several side effects. Recently, 500 microg neostigmine administered intraarticularly was shown to produce postoperative analgesia without side effects. The authors' goal was to determine whether 500 microg neostigmine added to mepivacaine in axillary plexus block prolongs postoperative analgesia. In addition, they wanted to determine the incidence of side effects in patients undergoing hand surgery. Methods Sixty-nine outpatients scheduled for carpal tunnel syndrome repair with axillary plexus block were randomly assigned to one of three groups that received saline solution in the axillary plexus and subcutaneously (group 1), 500 microg neostigmine in the axillary plexus and saline solution subcutaneously (group 2), or saline solution in the axillary plexus and 500 microg neostigmine subcutaneously (group 3). Sensory and motor block in the four hand nerve distributions were assessed every 5 min for 30 min The duration of the sensory and motor blocks were assessed after operation. Side effects were also recorded. Results Neostigmine had no effect on sensory and motor block in any of the four nerve distributions, nor did it increase the median duration of sensory block (215 min; range, 120-330 min) compared with group 1 (247 min; range, 190-287 min) or group 3 (236 min; range, 160-280 min). Motor block was slightly shorter (P = 0.045) in group 3 (190 min; range, 135-285 min) compared with group 1 (218 min; range, 145257 min) and group 2 (215 min; range, 105-343 min). Gastrointestinal side effects occurred in 30% of patients in both neostigmine groups but not in group 1 (P &lt; 0.05). Conclusions This study suggests that 500 microg neostigmine added to mepivacaine in axillary plexus block does not prolong postoperative sensory block, but it does cause a relatively high incidence of side effects. These two findings raise doubts about the use of neostigmine associated with local anesthetics for plexus neural block.

scholarly journals Evaluation of anxiolytic effect of furosemide in Albino rats

2018 ◽  
Vol 7 (2) ◽  
pp. 337
Author(s):  
Malvika Goyal ◽  
Jyothi C. H. ◽  
Rahul H. Damodar
Keyword(s):  
Locomotor Activity ◽  
Side Effects ◽  
Test Group ◽  
Anxiolytic Effect ◽  
Anxiolytic Activity ◽  
Threshold Dose ◽  
Control Group ◽  
Albino Rats ◽  
Group 2 ◽  
Group 1

Background: Anxiety disorders are the most prevalent class of psychiatric condition. Medications commonly given for treatment can elicit several central nervous system (CNS) side-effects that patients find difficult to tolerate. So there is a need for new pharmacotherapeutic approaches to treat anxiety with greater efficacy and fewer side effects. Hence this study has been taken up to evaluate the anxiolytic effect of furosemide at three different doses (75mg/kg, 150mg/kg and 200mg/kg) in Albino rats.Methods: After obtaining approval from the institutional animal ethical committee 30 Albino rats weighing about 150-200gm were taken and divided into 5 groups of 6 rats each. Group 1: Normal Saline 10ml/kg (control); Group 2: Diazepam 2mg/kg (standard); Group 3: Furosemide 150mg/kg (test group 1); Group 4: Furosemide 200mg/kg (test group 2); Group 5: Furosemide 75mg/kg + Diazepam 1mg/kg (sub threshold dose). The anxiolytic activity of furosemide was tested by elevated plus maze and digital actophotometer models. Data was analysed using one way ANOVA followed by Posthoc Tukey’s test.Results: Furosemide (150mg/kg and 200mg/kg) have shown significant increase in open arm entries (p<0.05) and time spent in open arm (p<0.05) compared to control. Also furosemide (150mg/kg and 200mg/kg) have shown statistically significant decrease in locomotor activity (p<0.05) compared to control in actophotometer model. Potentiation of time spent and number of entries in open arm and decrease in locomotor activity were noticed when sub threshold doses of combination of diazepam and furosemide were used.Conclusions: These results suggest that furosemide possesses significant anxiolytic activity at both the doses. Furosemide given in sub threshold dose potentiates the antianxiety effect of sub threshold dose of diazepam when used in combination. Hence, after further studies, furosemide can be used as an anxiolytic drug.

Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study)

2014 ◽  
Vol 30 (8) ◽  
pp. 525-532 ◽  
Author(s):  
C Hamel-Desnos ◽  
P Desnos ◽  
F-A Allaert ◽  
P Kern ◽  
Keyword(s):  
Side Effects ◽  
Prospective Study ◽  
Thermal Ablation ◽  
Cardiac Insufficiency ◽  
Control Group ◽  
Saphenous Veins ◽  
Group 2 ◽  
Multicenter Prospective Study ◽  
A Prospective Study ◽  
Group 1

Objectives To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years). Method An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher. Results EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0–10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10). Conclusion TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.

Are There Cochlear Dead Regions Involved in Hearing Loss after Cisplatin Ototoxicity?

2019 ◽  
Vol 24 (5) ◽  
pp. 253-257 ◽  
Author(s):  
Christiane Schultz ◽  
Patricia Helena Pecora Liberman ◽  
Maria Valéria Schmidt Goffi-Gomez
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Absolute Threshold ◽  
Control Group ◽  
Study Group ◽  
Chemotherapy Treatment ◽  
Cross Sectional ◽  
Group 2 ◽  
Cochlear Dead Regions ◽  
Group 1

Background: The most common complaint of patients affected by chemotherapy-induced hearing loss is difficulty understanding speech in noisy environments despite the use of hearing aids. Cochlear dead regions, those areas with damaged or absent inner hair cells and dendrites, may account for this type of hearing loss. However, it is unknown whether this condition is associated with cisplatin agents. Objective: The aim of this study was to determine whether cisplatin is associated with hearing loss and cochlear dead regions. Methods: This prospective cross-sectional study was conducted in patients participating in routine audiological monitoring during and after chemotherapy treatment. Adults undergoing audiological evaluation who had completed chemotherapy treatment were invited to participate. Patients were divided into 3 groups according to pure tone thresholds. Group 1 patients had thresholds over 70 dB (HL) at 2,000 Hz and higher frequencies. Group 2 patients had thresholds below 70 dB (HL) up to 2,000 Hz. Patients in the control group had normal thresholds at all frequencies. The threshold equalizing noise test (TEN[HL]) was used to identify cochlear dead regions by repeating thresholds in the presence of TEN noise played from a compact disc. The presence of cochlear dead regions was established when the masked threshold was 10 dB or greater above the TEN level and 10 dB or greater above the absolute threshold at any frequency. Results: Twelve patients were included in study group 1, 10 patients in study group 2, and 7 patients in the control group. Cochlear dead regions were present in all patients with hearing loss and in none of the control group. For groups 1 and 2, mean differences between absolute and masked thresholds were 21 and 16 dB at 500 Hz; 22 and 15 dB at 1,000 Hz; 31 and 17 dB at 2,000 Hz; 32 and 20 dB at 3,000 Hz; and 31 and 21 dB at 4,000 Hz, respectively. Nevertheless, analysis of variance testing with Bonferroni analysis showed a difference between groups 1 and 2 only at 2,000, 3,000, and 4,000 Hz. Conclusion: We found unresponsive or dead cochlear regions in patients who had undergone cisplatin chemotherapy even among patients with mild to moderate hearing loss.

scholarly journals Histopathology of placenta in intrauterine growth restriction (IUGR)

2019 ◽  
Vol 7 (3) ◽  
pp. 889 ◽  
Author(s):  
Ruchi Khajuria ◽  
Megha Sharma
Keyword(s):  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
Control Group ◽  
Case Group ◽  
Cross Sectional ◽  
Group 2 ◽  
Microscopic Measurement ◽  
Term Baby ◽  
Normal Placenta ◽  
Group 1

Background: Birth of healthy term baby depends on normal placenta. IUGR is a condition associated with placental insufficiency. There is a close relationship between IUGR and placental qualitative changes. The aim of the present study was to evaluate the morphological and histological changes in placentas of IUGR fetuses and in placentas of normal uncomplicated pregnancies and to determine the relationship that exists between morphological change and frequency of IUGR.Methods: In a cross sectional study conducted in the department of Pathology, GMC Jammu, a total of 60 placenta were received, 30 placenta of IUGR fetus (group 1-case) and 30 placenta of uncomplicated pregnancy with normal single fetus (group 2-control). Exclusion criteria: Twin pregnancy, gestational hypertension, diabetes, congenital anomaly, antepartum hemorrhage and systemic disorder.Results: Placental weights in IUGR group were significantly lower than control group. Average placental weight in IUGR group was 425 gms while in the control group (normal placenta) it was 550 gms. Infarction, intervillous thrombosis, chorionic villitis, hemorrhagic endovasculitis, placental intravascular thrombi, perivillous fibrin deposition, fibrinoid necrosis and villous edema were found to be more common in IUGR group (Group 1-case group) than Normal (Group 2- control group).Conclusions: This study highlightened that significant pathological differences were found between the placentas of IUGR fetus and normal fetus. The gross and microscopic measurement of a placenta is a good way to get proper information about IUGR and helps in management of the pregnancy.

scholarly journals THỰC TRẠNG DÙNG THUỐC GIẢM ĐAU SAU PHẪU THUẬT

2021 ◽  
Vol 62 (2) ◽  
Author(s):  
Trần Nhật Anh ◽  
Đỗ Văn Mãi ◽  
Bùi Tùng Hiệp ◽  
Bùi Đặng Minh Trí
Keyword(s):  
General Hospital ◽  
General Surgery ◽  
Descriptive Study ◽  
Combination Drug ◽  
Cross Sectional ◽  
Relieve Pain ◽  
Post Operation ◽  
Group 2 ◽  
Surgery Department ◽  
Group 1

Objective: To describe the current situation of post-operation painkillers use at the general surgery department of Cai Nuoc General Hospital. Objects and methods: Cross-sectional descriptive study on 172 patients undergoing surgery at General Surgery Department, Cai Nuoc General Hospital. Results: Mainly using paracetamol for pain relief, accounting for 98.98%. For epidural painkillers (levobupivacaine and fentanyl), the rate of use decreased significantly when comparing group 1 with group 2. This difference was statistically significant (p <0.05). The average number of drugs studied by patients in both groups for post-operative painkillers was 3.3 ± 1.2 types. Group 1 had patients using the main combination of drugs for post-operative painkillers was epidural (Levobupivacaine, fentanyl) + Ketorolac + Paracetamol with the rate of 48.81%. Group 2 had patients using a combination of drugs mainly to relieve pain after surgery was Morphin + Ketorolac + Paracetamol with the rate of 40.91%. Conclusion: Paracetamol was the primary painkillers. The average number of drugs for post-operative painkillers was 3.3 ± 1.2 types. Group 1 patients using the combination drug was epidural mainly (Levobupivacaine, fentanyl) + Ketorolac + Paracetamol. Group 2 patients using the combination of drugs was Morphin + Ketorolac + Paracetamol, mainly.

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