Comparison of Preemptive Analgesic Effects of Intravenous Ketorolac and Oral Pregabalin in Patients Undergoing Mandibular Fracture Surgery: A Randomized Clinical Trial

Background: Preemptive analgesia is one of the techniques to manage postoperative pain, which increases patient satisfaction and decreases the duration of hospitalization. The present study aimed to evaluate and compare the pain relief achieved by preoperative intravenous ketorolac and oral pregabalin in patients undergoing surgery for mandibular fractures. Methods: In the present clinical trial, 60 patients with unilateral fractures of the mandible were randomly assigned to two groups. In group A, intravenous injections of ketorolac 30 mg and in group B, pregabalin 150 mg capsules were administrated one hour preoperatively. The severity of pain was determined using a visual analog scale (VAS) up to 24 hours postoperatively. Finally, the total doses of an opioid analgesic (pethidine) prescribed for each patient in mg during the first 24 hours and the time for the request of the first analgesic dose in minutes were recorded for each patient. Then, their means were compared between the two groups. Results: Maximum pain severity was experienced immediately after surgery, which decreased gradually during the 24-hour postoperative period (P < 0.0001). The mean severity of pain immediately after regaining consciousness and the mean pain score during the 24-hour postoperative period were lower in the pregabalin group than in the ketorolac group (P < 0.0001). In the ketorolac group, a slightly higher dose of the opioid was administered; however, the difference was not significant (P > 0.05). Conclusions: The oral administration of pregabalin 150 mg one hour preoperatively was more effective than the intravenous administration of ketorolac 30 mg in relieving postoperative pain.

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Postoperative analgesia after lumbar disc surgery: A comparison between ketorolac and opioid

Journal of the Bangladesh Society of Anaesthesiologists ◽

10.3329/jbsa.v23i2.18175 ◽

2014 ◽

Vol 23 (2) ◽

pp. 56-61

Author(s):

Md Mustafa Kamal ◽

Abdullah Al Maruf ◽

Sabina Yeasmeen ◽

Abdul Hye

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Urinary Retention ◽

Postoperative Analgesia ◽

Lumbar Spine Surgery ◽

Surgical Closure ◽

Group A ◽

The Mean ◽

Group B ◽

Post Operative Nausea

Background Most spinal surgery is painful and good postoperative analgesia is important. Opioids are the traditional first-line treatment. Ketorolac has been used for postoperative pain relief. However, there is no data available about controlling postoperative pain with ketorolac after open lumbar discectomy or laminectomy in Bangladesah. Objective To compare the efficacy of a Parentral ketorolac with conventional opioid for management of postoperative pain after lumbar disectomy or laminectomy. Methods Sixty patients who underwent lumbar disectomy or laminectomy were randomly allocated into two groups. Group A (n = 30) patients received 30 mg intramuscular ketorolac upon surgical closure and every 6 hours for 24 hours and intramuscular pethidine 1.5 mg/kg/b.w. as needed (PRN). Group B (n = 30) patients received only intramuscular pethidine 1.5 mgkg-1/b.w. every 6 hours for 24 hours and as needed (PRN). Postoperative analgesia was assessed in both groups by Visual Analogue Scale at arrival in postoperative ward and at 6, 12 and 24 hours for 24 hours. Total postoperative narcotic consumption and side effects like post operative nausea and vomiting (PONV), dizziness, urinary retention and pruritus were also recorded. Results Baseline data were comparable between the two groups. The mean VAS almost similar and less than 3 at different reading in both groups which indicate adequate postoperative analgesia and the differences were statistically not significant. The mean total cumulative amount of pethidine administered over 24 hrs period was less in group A it was 64.31+19.13 mg where as in group B was 161.23+21.25 mg. and the difference was statistically significant (p<0.01). Incidences of side effects like PONV, urinary retention and pruritus were more in group B than group A and differences were statistically significant (p<0.01). Conclusion For postoperative pain management after lumbar spine surgery both ketorolac and traditional parental opioid found effective. Total opioid consumption is significantly less with ketorolac and side effects like PONV, dizziness, urinary retention and pruritus were more with opioid alone. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18175 Journal of BSA, 2009; 23(2): 56-61

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Comparison the Efficacy of Intranasal Ketamine Versus Intravenous Ketorolac on Acute Non-Traumatic Headaches: A Randomized Double-Blind Clinical Trial

10.21203/rs.3.rs-99460/v1 ◽

2020 ◽

Author(s):

Houman Rafiee Sarvari ◽

Hamidreza Baigrezaii ◽

Mohammad Nazarianpirdosti ◽

Amirhossein Meysami ◽

Roya Safari-Faramani

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Double Blind ◽

Analgesic Effects ◽

Headache Severity ◽

Selective Approach ◽

Double Blind Clinical Trial ◽

Group B ◽

Short Time ◽

Intravenous Ketorolac

Abstract Introduction: Non - traumatic headaches are one of the most common causes of referral to hospital emergency. This study aimed to compare the efficacy of intranasal ketamine and intravenous ketorolac on acute non-traumatic headaches.Methods: This randomized and double-blind clinical trial in 2019 years. 140 people were randomly divided into intranasal ketamine (A) and intravenous ketorolac (B). Group (A) received ketamine intranasal (0.75 mg/kg, max 75mg), and group B received intravenous ketorolac (30 mg). Headache severity was measured on arrival, 30, 60, and 120 minutes after intervention with Visual Analogue Scale (VAS). The side effects were recorded an hour after the intervention.Result: The mean difference of pain intensity 30, 60, and 120 minutes after the intervention between the two groups were statistically significant (p<0.001). In the first 30 minutes, significant changes were observed in the VAS levels of the two groups. These changes were more and significant in the intranasal ketamine group (p <0.001). Side effects such as fatigue, dizziness, public discomfort, nausea, increased heart rate, and hypertension were significantly higher in the ketamine group (p <0.05).Conclusion: Intranasal ketamine and intravenous ketorolac both effectively reduced headaches. However, more analgesic effects of intranasal ketamine in a short time can be considered as a selective approach to reducing headaches.

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Comparison the Efficacy of Intranasal Ketamine Versus Intravenous Ketorolac on Acute Non-traumatic Headaches: A Randomized Double-Blind Clinical Trial

10.21203/rs.3.rs-97688/v1 ◽

2020 ◽

Author(s):

Houman Rafiee Sarvari ◽

Hamidreza Baigrezaii ◽

Mohammad Nazarianpirdosti ◽

Amirhossein Meysami ◽

Roya Safari-Faramani

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Double Blind ◽

Analgesic Effects ◽

Headache Severity ◽

Selective Approach ◽

Double Blind Clinical Trial ◽

Group B ◽

Short Time ◽

Intravenous Ketorolac

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Comparative Study between the Use of Self-Fixating Mesh and Non Self-Fixating Mesh in Laprascopic Inguinal Hernia Repair Transabdominal Preperitoneal (TAPP) Technique

QJM ◽

10.1093/qjmed/hcaa042.008 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

E F Ebied ◽

A A Khalil ◽

A I I Soliman

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Comparative Study ◽

Inguinal Hernia Repair ◽

Inguinal Hernioplasty ◽

Vas Score ◽

Group A ◽

The Mean ◽

Group B

Abstract Background Hernia is a common problem of the modern world with an incidence ranging from 5%-7%. Of all groin hernias, around 75% are inguinal hernias. Recently with advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work. Aim of the Work To compare between self fixating mesh and non self fixating mesh in laproscopic inguinal hernia repair transabdominal preperitoneal (TAPP) approach as regards intraoperative time, complications, postoperative pain, return to normal activity and incidence of recurrence. Patients and Methods This study was conducted on 30 adult patients presenting with inguinal hernias. They were divided into 2 equal groups of 15 patients each. The first group (A): includes fifteen patients and was operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique using self -gripping (SGM group) (Parietex ProGrip] Laparoscopic (PPL) meshes), while the second group (B): includes fifteen patients and were operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique with non-self fixating mesh. Results The postoperative pain assessment at 24 hours and 4 weeks shows that the mean VAS score for GROUP A was (3.70 ± 1.72) and for GROUP B (3.90 ± 1.25) while after 1 month duration follow up, the mean VAS score was (1.25 ± 0.79) for Group A and (1.20 ± 0.77) for Group B with no difference between the two groups confirming the atraumatic nature of the self gripping mesh. Conclusion After this comparative study, both mesh fixation with absorpable tacks and fixation using SGM approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature.

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Clinical trial to assess role of ketamine in post operative analgesia after laparoscopic cholecystectomy

Journal of University of Shanghai for Science and Technology ◽

10.51201/jusst/21/05166 ◽

2021 ◽

Vol 23 (05) ◽

pp. 421-432

Author(s):

Dr. Mohammad Kheiri Mahmod ◽

◽

Dr. Bashar Naser Hussein ◽

Dr. Ammar Hamid Hanoosh ◽

◽

...

Keyword(s):

Clinical Trial ◽

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Analgesic Effect ◽

Analgesic Requirement ◽

Pain Scores ◽

Post Operative Pain ◽

Significant Difference ◽

Group A ◽

Group B

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.

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TO COMPARE THE EFFECTIVENESS OF INTERMAXILLARY FIXATION USING ERICH ARCH BAR AND SCREWS IN MANDIBULAR FRACTURES – A RANDOMIZED CLINICAL STUDY.

10.36106/ijsr/6226154 ◽

2021 ◽

pp. 24-27

Author(s):

Ayeshwarya Chaudhary ◽

Aashish Deshmukh ◽

Manasi Bavaskar ◽

Mehul Bhoye ◽

Rajwardhan Shinde

Keyword(s):

Mandibular Fracture ◽

Mandibular Fractures ◽

Intermaxillary Fixation ◽

Glove Perforation ◽

Randomized Clinical Study ◽

Arch Bar ◽

Group A ◽

The Mean ◽

Group B ◽

Mean Time

Purpose: Intermaxillary xation (IMF) is an essential principle in the management of mandibular fractures; but with the recent advent of open reduction and internal xation (ORIF), the use of IMF is almost limited to intraoperative procedure only. This study aims to investigate and compare the effectiveness of Erich arch bar & intermaxillary xation (IMF) screws for the management of mandibular fractures. Materials And Method: A randomized prospective study was conducted on 20 patients with mandibular fracture, who were randomly allotted to two groups. Group A patients received intermaxillary xation using Erich arch bar and group B patients received IMF screws. The parameters assessed were time taken for application and removal of appliance, stability of occlusion, glove perforation, and pre-and post-operative plaque accumulation. Results: The mean time for placement of the Erich arch bar was 43.10 minutes as compared to 18.60 minutes with intermaxillary xation screws. Better occlusal stability was shown with an arch bar over IMF screws, and was statistically signicant. More glove tears or penetrations occurred during application in group A than Group B (p<0.01). Also, The Plaque Index assessment on removal of appliance showed a statistically signicant difference between the two groups; higher in the arch bar group. Conclusion: This study indicates that with acceptable occlusal stability, IMF screws technique is an effective and favourable alternative to Erich arch bars for temporary intermaxillary xation in mandibular fractures.

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Randomized Trial of Silver Nitrate with Sodium Fluoride for Caries Arrest

JDR Clinical & Translational Research ◽

10.1177/2380084418818482 ◽

2019 ◽

Vol 4 (2) ◽

pp. 126-134 ◽

Cited By ~ 7

Author(s):

S.S. Gao ◽

D. Duangthip ◽

M.C.M. Wong ◽

E.C.M. Lo ◽

C.H. Chu

Keyword(s):

Clinical Trial ◽

Preschool Children ◽

Silver Nitrate ◽

Randomized Clinical Trial ◽

Sodium Fluoride ◽

Silver Diamine Fluoride ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

Objectives: The aim of this noninferiority double-blind randomized clinical trial was to compare the effectiveness of the topical semiannual application of a 25% silver nitrate (AgNO3) solution followed by a 5% sodium fluoride (NaF) varnish with that of a 38% silver diamine fluoride (SDF) solution in arresting caries among preschool children. Methods: Healthy 3-y-old children with active dentine carious lesions were randomly allocated to 2 groups via computer-generated random numbers. Lesions in group A received applications of a 25% AgNO3 solution followed by a 5% NaF varnish semiannually (every 6 mo). Lesions in group B received semiannual applications of a 38% SDF solution followed by a placebo varnish. A trained examiner recorded the status of caries and oral hygiene at baseline and during follow-up examinations. The examiner, children, and their caretakers were blinded to the intervention allocation. This study adopted an intention-to-treat analysis. A noninferiority test was conducted for the data analysis. Group A’s noninferiority was accepted if the lower limit of the 95% CI for the difference in the mean number of arrested surfaces was >−0.5. Results: A total of 1,070 children were recruited at baseline, with 535 children in each group. After 18 mo, the mean ± SD number of arrested surfaces was 3.3 ± 3.4 in group A (n = 484) and 3.2 ± 3.5 in group B (n = 476; P = 0.664). The difference in the mean number of arrested surfaces between the groups was 0.092 (95% CI, −0.322 to 0.505). Apart from black staining on the arrested lesions, no other significant side effect was observed. Conclusion: A semiannual application of 25% AgNO3 followed by 5% NaF is no worse than a 38% SDF in arresting dentine caries among preschool children over 18 mo. The Hong Kong Research Grants Council (GRF 17107315) funded this trial, which was registered at ClinicalTrials.gov (NCT02019160). Knowledge Transfer Statement: This randomized clinical trial found that silver nitrate solution followed by sodium fluoride varnish is effective in arresting dentine caries among preschool children. As silver nitrate followed by sodium fluoride is a noninvasive and simple protocol, it can be an alternative strategy to manage dental caries among young children, especially in countries where silver diamine fluoride is not available.

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COMPARATIVE EVALUATION OF THE EFFICACY OF 4% MANGOSTEEN GEL AND 1% CHLORHEXIDINE DIGLUCONATE GEL IN MANAGEMENT OF PATIENTS WITH CHRONIC GINGIVITIS: A RANDOMIZED CLINICAL TRIAL

International Journal of Research in Ayurveda and Pharmacy ◽

10.7897/2277-4343.1206161 ◽

2022 ◽

Vol 12 (6) ◽

pp. 6-11

Author(s):

Vinayaka A.M. ◽

Gayathri G.V. ◽

Triveni M.G.

Keyword(s):

Clinical Trial ◽

Plaque Index ◽

Age Group ◽

Chlorhexidine Digluconate ◽

Gingival Index ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.

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Single Dose or Divided Dose of Polyethylene Glycol in Treatment of Pediatric Functional Constipation: A Randomized Clinical Trial

10.21203/rs.3.rs-977795/v1 ◽

2021 ◽

Author(s):

Heidar Safarpour ◽

Mohammad Hadi Imanieh ◽

naser honar ◽

sajad hekmati ◽

Naeimehossadat Asmarian

Keyword(s):

Clinical Trial ◽

Single Dose ◽

Polyethylene Glycol ◽

Randomized Clinical Trial ◽

Divided Dose ◽

Functional Constipation ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.

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Comparison between the mean postoperative pain score with two different file systems in patients with irreversible pulpitis-a clinical study in Altamash Institute of Dental Medicine.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.89 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1359-1364

Author(s):

Sara Jamil ◽

Rizwan Jouhar ◽

Dinaz Gandhi ◽

Tayyaba Tahira ◽

Jamshed Shaikh

Keyword(s):

Stainless Steel ◽

Postoperative Pain ◽

Pain Score ◽

T Test ◽

Postoperative Pain Score ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

Irreversible Pulpitis

Endodontic Pain if occurs after few hours or days after the treatment indicates a poor pathosis and a bad prognosis in long term, due to this a newer generation of instruments for canal treatment has been introduced from Ni-Ti alloy which has even better ability to shape narrow and curved root canals, without causing aberration. To compare the mean postoperative pain score after manual SS (stainless steel) K-files and mechanical Ni-Ti rotary path files in patients with irreversible pulpitis. Study Design: Randomized controlled trial. Setting: Department of Operative Dentistry, Altamash Institute of Dental Medicine, Karachi. Period: 6 months from 01-10-2017 to 30-03-2018. Materials and Methods: Total 60 patients of irreversible pulpitis with moderate pain score ≥5 were included and divided equally in manual stainless-steel k-files and mechanical Ni-Ti rotary path files groups. Treatment was started with local anesthesia. Patients were recalled after 24 hours and the level of postoperative pain was examined. T-test was applied to compare the outcome in both groups. Stratification was done using t-test and P value ≤0.05 was significantly considered. Results: The mean pre-treatment VAS in group-A and group-B was 7.16±1.44 and 7.86±1.38 respectively. Mean post-treatment VAS in group-A and group-B was 2.33±1.02 and 1.10±0.66 respectively. A significant difference between the pre and post op pain was noted between the two groups, when compared after 24hours by using VAS. Conclusion: Mean post-operative pain score was significantly less with NiTi rotary path files as compare to manual stainless steel K-files.

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