scholarly journals PENGARUH INTRADYALITIC EXERCISE TERHADAP PENURUNAN NYERI PASIEN HEMODIALISA RUTIN DI UNIT HEMODIALISA RSUD Dr. TJITROWARDOJO PURWOREJO

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Wiwit Sugiarti ◽  
Sri Nabawiyati Nurul Makiyah ◽  
Azizah Khoiriyati
Keyword(s):  
Visual Analog Scale ◽  
Control Group ◽  
P Value ◽  
Analog Scale ◽  
Intradialytic Exercise

Latar belakang; Nyeri muskuloskeletal merupakan gejala yang dialami pasien gagal ginjal kronik yang menjalani hemodialisa.Manajemen nyeri dapat menggunakan distraksi relaksasi konvensional dan intradialytic exercise. Penelitian ini bertujuan untuk mengetahui efektivitas Intradialytic exercise dalam menurunkan nyeri pada pasien hemodialisa rutin di Unit Hemodialisa Rumah Sakit Umum Daerah Dr. Tjitrowardojo Purworejo.Metode; Rancangan penelitian yang digunakan eksperimen semu dengan desain pretest-posttest with control group. Respondennya 36 orang, terdiri dari 18 pasien yang diberi Intradialytic exercise sebagai kelompok intervensi dan 18 pasien lainnya hanya diberikan distraksi-relaksasi konvensional sebagai kelompok kontrol.  Pengukuran nyeri menggunakan Visual Analog Scale. Analisis datanya menggunakanPaired t Testdan  Independent Sample t Test.Hasil;  Hasil penelitian didapatkan perbedaan penurunan yang signifikan terhadap skor nyeri pre dan postes pada kelompok baik intervensi dan kelompok kontrol dengan p value 0,000 (p< 0,005 dan metode Intradialytic exercise lebih efektif dalam menurunkan skor nyeri dibandingkan metode distraksi-relaksasi konvensional pada pasien HD rutin  dengan p value 0,000 (p< 0,005). Kata kunci: Intradialytic Exercise, Nyeri

scholarly journals PENURUNAN NYERI DENGAN KOMPRES DINGIN DI LEHER BELAKANG (TENGKUK) PADA PASIEN POST HEMOROIDEKTOMI TERPASANG TAMPON

2018 ◽  
Vol 1 (1) ◽  
pp. 8-12
Author(s):  
Rohmani Rohmani ◽  
Debi Dahlia ◽  
Lestari Sukmarini
Keyword(s):  
Visual Analog Scale ◽  
Control Group ◽  
P Value ◽  
Test Design ◽  
Analog Scale ◽  
Post Test ◽  
Quasi Experiment

Pasien post hemoroidektomi yang terpasang tampon mengalami nyeri akibat adanya spasme internal yang disebabkan oleh regangan dan tekanan syaraf perifer dikanalis analis. Penelitian ini bertujuan mengetahui pengaruh kompres dingin di leher belakang (tengkuk) terhadap penurunan nyeri pada pasien post hemoroidektomi yang terpasang tampon. Penelitian ini menggunakan quasi experiment pre test post test design with control group dengan jumlah responden yang didapat dengan teknik concecutive sampling. Pengukuran skala nyeri menggunakan visual analog scale (VAS) dengan skor nyeri maksimal 8. Hasil uji Friedman menunjukkan adanya perbedaan rerata penurunan nyeri yang diberikan kompres dingin ditengkuk dengan p-value 0,0001. Tindakan kompres dingin lebih efektif dibandingkan dengan terapi standar dalam menurunkan skala nyeri pasien post hemoroidektomi yang terpasang tampon. Penelitian ini bertujuan untuk mengukur penurunan nyeri dengan kompres dingin di leher belakang pada pasien post hemoroidektomi terpasang tampon.

scholarly journals Preoperative lidocaine infusion for the pain management in laparotomy procedures: a randomized control trial

2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Hamid Raza ◽  
Ahmed Uddin Soomro ◽  
Maqsood Ahmed Siddiqui ◽  
Kamlaish ◽  
Muhammad Sheraz Raza Naqvi
Keyword(s):  
Pain Management ◽  
Visual Analog Scale ◽  
Randomized Control Trial ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Care Hospital ◽  
Analog Scale ◽  
Significant Difference ◽  
Randomized Control

Objectives: To evaluate the role of pre-operative lidocaine infusion for pain management in laparotomy procedures. Study Design: Prospective double blind randomized control trial. Period: 8 months duration from April 2017 to November 2017. Setting: Tertiary care hospital in Karachi, Pakistan. Method: N= 50 patients belonging to ASA Classification types I and II were selected to be part of this study. All the patients underwent major abdominal surgeries (laparotomy). The study group received lidocaine 2%, 1.5mg/kg IV bolus half an hour before induction, followed by an infusion of 1.5mg/kg/hour. The anesthesia was induced with fentanyl 3ug/kg, propofol 2mg/kg, followed by rocuronium 1mg/kg to intubate the patient. Maintenance was done with using 33% nitrous oxide in oxygen along with 0.8% of isoflurane. Fentanyl was administered as an infusion initiating prior to the procedure with a maximum dose of 1ug/kg/hour and ceasing the infusion half an hour prior to end of procedure. Visual analog scale was used to measure the pain intensity at an interval of twenty minutes during the first hour of the procedure, and at 2,4,8,12,24 and 48 hours after the end of the procedure. If the visual analog scale score was found to be more than 3, 1 to 3mg of Morphine was administered every ten minutes up to a dose of 0.1mg/kg intravenously. A proforma was used to collect data, data was analyzed using IBM SPSS version 21.0. Results: The study was conducted on n=50 patients, with a mean age of 38.35 years in the study group and 36.48 years in the control group. The intensity of pain was found to be significantly less in the case group as compared to the control group having a p value of <0.001 during the first 48 hours of the procedure. Decreased consumption of morphine was observed in patients in the study group, as compared to the control group with a statistically significant difference, having a p value of less than <0.05. In our study we did not observe any side effects related to toxicity levels of lidocaine or morphine. Conclusion: Our study confirms the results of previously done studies, and we found that in our patient population Perioperative lidocaine infusion decreased the post-operative pain experienced by the patient and decreased the need for consumption of analgesics. Thus we conclude that lidocaine infusion perioperatively is an effective pain management modality.

scholarly journals Pengaruh pemberian teknik relaksasi genggam jari terhadap persepsi nyeri pada pasien post operasi fraktur

2021 ◽  
Vol 18 (1) ◽  
pp. 13-24
Author(s):  
Ucik Indrawati ◽  
Afif Hidayatul Arham
Keyword(s):  
Visual Analog Scale ◽  
Control Group ◽  
P Value ◽  
Analog Scale ◽  
Whitney Test ◽  
Consecutive Sampling ◽  
Mann Whitney Test

Fraktur merupakan terputusnya kontinuitas jaringan tulang rawan yang umumnya disebabkan oleh trauma. Post operasi fraktur menimbulkan nyeri yang hebat pada pasien sehingga membutuhkan perawatan untuk menurunkan persepsi nyeri tersebut. Tujuan penelitian untuk mengetahui pengaruh pemberian teknik relaksasi genggam jari terhadap persepsi nyeri post operasi fraktur. Desain penelitian ini adalah quasi eksperiment dengan pretest-postest with control group. Pengambilan sampel menggunakan consecutive sampling. Jumlah sampel adalah 42 orang (21 orang kelompok intervensi dan 21 orang kelompok kontrol). Nyeri diukur dengan Visual Analog Scale. Analisis statistik menggunakan non parametrik (Wilcoxon dan Mann Whitney Test). Hasil analisis terhadap jenis kelamin mayoritas laki-laki (69%), hampir separuhnya berusia 17-25 tahun (45,2%), sebagian besar berpendidikan menengah (61,9%), mayoritas beragama Islam (97,6%), mayoritas belum pernah operasi (97,6%). Hasil analisis statistik dengan Wilcoxon p-value nyeri sebelum dan sesudah pada kelompok intervensi (p=0,000); nyeri sebelum dan sesudah pada kelompok kontrol (p=0,030). Kesimpulan dalam penelitian ini adalah ada pengaruh pemberian teknik relaksasi genggam jari terhadap persepsi nyeri pada pasien post operasi fraktur.

scholarly journals The effect of local ketamine infiltration on post tonsillectomy pain scale

2020 ◽  
Vol 50 (1) ◽  
pp. 38
Author(s):  
Ade Asyari ◽  
Novialdi Novialdi ◽  
Elniza Morina ◽  
Rimelda Aquinas ◽  
Nasman Puar ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Secondary Infection ◽  
Pain Scale ◽  
Control Group ◽  
Analog Scale ◽  
Noticeable Effect ◽  
Local Infiltration ◽  
Significant Difference ◽  
Post Test ◽  
Test Control

Background: Post tonsillectomy pain is one of the surgery side effects that most disturbing for patient’s comfort and will cause dysphagia, low intake, dehydration, secondary infection and bleeding. Ketamine is an anesthetic drug that has strong analgesic effect and easily available in any hospital at relatively cheap price. Objective: To find out the effect of local ketamine infiltration on the post tonsillectomy pain scale. Method: An experimental study during tonsillectomy with a Post Test Control Group on 12 samples without local infiltration of ketamine and 12 samples with local infiltration of ketamine in peritonsillar pillar. The pain was assessed 2 hours and 24 hours post extubation with pain Visual Analog Scale (VAS). Result: The VAS value from patients who were given local infiltration of ketamine in peritonsillar pillar were lower (5.83 ± 0.72 at 2 hours and 2.83 ± 0.58 at 24 hours post extubation) compared to patients without ketamine infiltration (7.83 ± 0.58 at 2 hours and 3.58 ± 0.51 at 24 hours post extubation). The result showed statistically significant difference (p <0.05) at 2 hours and 24 hours post extubation. Conclusion: The VAS score of the ketamine infiltration group is lower at 2 hours and 24 hours post extubation than the group without ketamine infiltration, showing there was a noticeable effect of local ketamine infiltration on the post tonsillectomy pain scale.Keywords : post tonsillectomy pain, ketamine, local infiltration, visual analog scale ABSTRAKLatar belakang: Nyeri pascatonsilektomi adalah salah satu efek samping operasi yang sangat mengganggu kenyamanan pasien, dan dapat menyebabkan gangguan menelan, kurangnya asupan nutrisi, dehidrasi, infeksi sekunder dan perdarahan. Ketamin merupakan obat anestesi yang memiliki efek analgetik yang kuat dan mudah didapatkan di semua tipe rumah sakit dengan harga yang relatif murah. Tujuan: Mengetahui efek pemberian infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi. Metode: Penelitian eksperimental dengan desain Post Test Control Group pada 12 sampel tanpa pemberian infiltrasi lokal ketamin dan 12 sampel dengan pemberian infiltrasi lokal ketamin di pilar peritonsil saat tonsilektomi. Dilakukan penilaian nyeri 2 jam dan 24 jam pascaekstubasi menggunakan skala nyeri Visual Analog Scale (VAS). Hasil: Nilai VAS pasien yang diberi infiltrasi lokal ketamin di pilar peritonsil lebih rendah (5,83±0,72 pada 2 jam dan 2,83 ± 0,58 pada 24 jam pascaekstubasi) dibanding tanpa diberi infiltrasi lokal ketamine (7,83 ± 0,58 pada 2 jam dan 3,58± 0,51 pada 24 jam pascaekstubasi), dan bermakna secara statistik (p<0,05) pada kedua penilaian. Kesimpulan: Terdapat efek nyata infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi, dimana nilai VAS kelompok yang diberi infiltrasi ketamin lebih rendah, baik pada 2 jam ataupun 24 jam pascaekstubasi dibanding kelompok yang tidak diberi infiltrasi ketamin.

scholarly journals Spinal cord stimulation for chronic intractable trunk or limb pain: study protocol for a Chinese multicenter randomized withdrawal trial (CITRIP study)

2020 ◽  
Author(s):  
Yang Lu ◽  
Peng Mao ◽  
Guihuai Wang ◽  
Wei Tao ◽  
Donglin Xiong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Visual Analog Scale ◽  
Spinal Cord Stimulation ◽  
Pulse Generator ◽  
Short Form ◽  
Control Group ◽  
Withdrawal Period ◽  
Analog Scale ◽  
Limb Pain ◽  
Vas Score

Abstract Background: Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain.Method：Participants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average Visual Analog Scale (VAS) score ≥ 5 will undergo spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-months follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre and post randomization) and 6 months. The primary outcome is the difference of maximal visual analog scale (VAS) score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1, 3 and 6-month follow-ups, responder rate (VAS score improving by 50%), achievement rate of a desirable pain state (VAS score ≤ 4), awake times during sleep, Beck Depression Inventory for depression evaluation, short-form 36 for quality of life evaluation, drug usage, satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle. Discussion：The CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.Trial registration: NCT03858790, clinicaltrials.gov, registered on March 1st, 2019, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03858790

Transdermal Nitroglycerine Enhances Spinal Neostigmine Postoperative Analgesia following Gynecological Surgery

2000 ◽  
Vol 93 (4) ◽  
pp. 943-946 ◽  
Author(s):  
Gabriela R. Lauretti ◽  
Ana-Paula M. Oliveira ◽  
Maria-do-Carmo C. Julião ◽  
Marlene P. Reis ◽  
Newton L. Pereira
Keyword(s):  
Adverse Effects ◽  
Visual Analog Scale ◽  
Postoperative Analgesia ◽  
Visual Analog Scale Score ◽  
Spinal Pain ◽  
Gynecologic Surgery ◽  
Control Group ◽  
Sensory Level ◽  
Analog Scale ◽  
American Society

Background Intrathecal neostigmine causes analgesia by inhibiting the breakdown of acetylcholine. Experimental data suggest that the production of endogenous nitric oxide is necessary for tonic cholinergic inhibition of spinal pain transmission. The purpose of this study was to determine whether association of transdermal nitroglycerine would enhance analgesia from a low dose of intrathecal neostigmine in patients undergoing gynecologic surgery during spinal anesthesia. Methods Forty-eight patients were randomized to one of four groups. Patients were premedicated with use of 0.05-0.1 mg/kg intravenous midazolam and received 15 mg bupivacaine plus 1 ml test drug intrathecally (saline or neostigmine, 5 microgram). Twenty to 30 min after the spinal puncture, a transdermal patch of either 5 mg nitroglycerin or placebo was applied. The control (Con) group received spinal saline and transdermal placebo. The neostigmine group received spinal neostigmine and transdermal placebo. The nitroglycerin group received spinal saline and a transdermal nitroglycerine patch. Finally, the neostigmine-nitroglycerin group received spinal neostigmine and transdermal nitroglycerine. Pain and adverse effects were evaluated using a 10-cm visual analog scale. Results Patients in the groups were similar regarding age, weight, height, and American Society of Anesthesiologists status. Sensory level to pin prick at 10 min, surgical duration, anesthetic duration, and visual analog scale score for pain at the time of administration of first rescue medication were statistically the same for all groups. The time to administration of first rescue analgesic (min) was longer in the neostigmine-nitroglycerin group (550 min; range, 458-1,440 min; median, 25-75th percentile) compared with the other groups (P &lt; 0.001). The neostigmine-nitroglycerin group required fewer rescue analgesics in 24 h than did the control group (P &lt; 0.0005), whereas the neostigmine group required less analgesics compared with the control group (P &lt; 0.02). The incidence of perioperative adverse effects (nausea, vomiting, headache, back pain) was similar among groups (P &gt; 0.05). Conclusion Although neither intrathecal 5 microgram neostigmine alone nor transdermal nitroglycerine alone (5 mg/day) delayed the time to administration of first rescue analgesics, the combination of both provided an average of 14 h of effective postoperative analgesia after vaginoplasty, suggesting that transdermal nitroglycerin and the central cholinergic agent neostigmine may enhance each other's antinociceptive effects at the dose studied.

scholarly journals Strength-Training Protocols to Improve Deficits in Participants With Chronic Ankle Instability: A Randomized Controlled Trial

2015 ◽  
Vol 50 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Emily A. Hall ◽  
Carrie L. Docherty ◽  
Janet Simon ◽  
Jackie J. Kingma ◽  
Joanne C. Klossner
Keyword(s):  
Strength Training ◽  
Visual Analog Scale ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Chronic Ankle Instability ◽  
Control Group ◽  
Analog Scale ◽  
Protocol Group ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Hop Test

Context: Although lateral ankle sprains are common in athletes and can lead to chronic ankle instability (CAI), strength-training rehabilitation protocols may improve the deficits often associated with CAI. Objective: To determine whether strength-training protocols affect strength, dynamic balance, functional performance, and perceived instability in individuals with CAI. Design: Randomized controlled trial. Setting: Athletic training research laboratory. Patients or Other Participants: A total of 39 individuals with CAI (17 men [44%], 22 women [56%]) participated in this study. Chronic ankle instability was determined by the Identification of Functional Ankle Instability Questionnaire, and participants were randomly assigned to a resistance-band–protocol group (n = 13 [33%] age = 19.7 ± 2.2 years, height = 172.9 ± 12.8 cm, weight = 69.1 ± 13.5 kg), a proprioceptive neuromuscular facilitation strength-protocol group (n = 13 [33%], age = 18.9 ± 1.3 years, height = 172.5 ± 5.9 cm, weight = 72.7 ± 14.6 kg), or a control group (n = 13 [33%], age = 20.5 ± 2.1 years, height = 175.2 ± 8.1 cm, weight = 70.2 ± 11.1 kg). Intervention(s): Both rehabilitation groups completed their protocols 3 times/wk for 6 weeks. The control group did not attend rehabilitation sessions. Main Outcome Measure(s): Before the interventions, participants were pretested by completing the figure-8 hop test for time, the triple-crossover hop test for distance, isometric strength tests (dorsiflexion, plantar flexion, inversion, and eversion), the Y-Balance test, and the visual analog scale for perceived ankle instability. Participants were again tested 6 weeks later. We conducted 2 separate, multivariate, repeated-measures analyses of variance, followed by univariate analyses on any significant findings. Results: The resistance-band protocol group improved in strength (dorsiflexion, inversion, and eversion) and on the visual analog scale (P &lt; .05); the proprioceptive neuromuscular facilitation group improved in strength (inversion and eversion) and on the visual analog scale (P &lt; .05) as well. No improvements were seen in the triple-crossover hop or the Y-Balance tests for either intervention group or in the control group for any dependent variable (P &gt; .05). Conclusions: Although the resistance-band protocol is common in rehabilitation, the proprioceptive neuromuscular facilitation strength protocol is also an effective treatment to improve strength in individuals with CAI. Both protocols showed clinical benefits in strength and perceived instability. To improve functional outcomes, clinicians should consider using additional multiplanar and multijoint exercises.

scholarly journals Efficacy and safety of intrathecal morphine for post cesarean section analgesia

2015 ◽  
Vol 1 (1) ◽  
pp. 13-17
Author(s):  
Rupesh Kumar Gami ◽  
Kumar Jahan ◽  
Chandra Bhushan Jha
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Visual Analog Scale ◽  
Intrathecal Morphine ◽  
Safe Motherhood ◽  
Control Group ◽  
Efficacy And Safety ◽  
Analog Scale ◽  
Morphine Group ◽  
Significant Difference

Background: Government of Nepal has been conducting Cesarean section under “Safe Motherhood” program all over country. The purpose of this study was to evaluate the efficacy and safety of intrathecal morphine for post cesarean analgesia under spinal anesthesia.  Methods: A total of 300 parturients posted for Cesarean section under spinal anesthesia were divided into two groups of 150 each in this prospective randomized case-control study. Morphine group received 0.15 mg of intrathecal morphine mixed in 12 mg of 0.5% bupivacaine heavy while control group received 12 mg of 0.5% bupivacaine heavy alone, after proper preparation of spinal anesthesia. The parturients were assessed for first request of analgesic as per Visual Analog Scale, frequency of analgesics required within 24 hr, nausea, vomiting, pruritus, sedation and respiratory depression.Results: Postoperative analgesia was significantly greater in morphine group as compare to control group (12.1 ± 7.6 vs 3.7 ± 2.9 hr). Frequency of analgesics requirements was also significantly lower in morphine group (1.7 ± 2.0 vs 3.4 ± 8.1). Visual Analog Scale was below 4 at most of time in morphine group. The incidence of nausea, vomiting and pruritus were more in morphine group as compare to control group but without any respiratory depression. There was no significant difference in APGAR score among fetus.  Conclusion: Mixing low dose of intrathecal morphine in standard dose of spinal anesthesia effectively prolongs the duration of post cesarean analgesia and decreases the frequency of analgesics requirement without any major complication in parturients or fetus.Journal of Society of Anesthesiologists 2014 1(1): 13-17

scholarly journals The Effect of 1,8-Cineole Inhalation on Preoperative Anxiety: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ka Young Kim ◽  
Hyo Jin Seo ◽  
Sun Seek Min ◽  
Mira Park ◽  
Geun Hee Seol
Keyword(s):  
Visual Analog Scale ◽  
Controlled Trial ◽  
Major Constituent ◽  
Control Group ◽  
Analog Scale ◽  
Almond Oil ◽  
Eucalyptus Oil ◽  
Significant Difference ◽  
Before And After ◽  
Selective Nerve Root Block

The aim of this study was to investigate the effect of inhalation of eucalyptus oil and its constituents on anxiety in patients before selective nerve root block (SNRB). This study was a randomized controlled trial carried out in 62 patients before SNRB. The patients were randomized to inhale limonene, 1,8-cineole, or eucalyptus oil, each at concentrations of 1% vol/vol in almond oil or almond oil (control). Anxiety-visual analog scale (A-VAS), state-trait anxiety inventory (STAI), profile of mood states (POMS), pain-visual analog scale (P-VAS), blood pressure, and pulse rate were measured before and after inhalation prior to SNRB. Measures of anxiety, including A-VAS (P<0.001), STAI (P=0.005), and POMS (P<0.001), were significantly lower in 1,8-cineole than in the control group and significantly greater in 1,8-cineole than in the eucalyptus group in A-VAS. P-VAS was significantly lower after than before inhalation of limonene, 1,8-cineole, and eucalyptus, despite having no significant difference in the four groups compared with control group. 1,8-Cineole, a major constituent of eucalyptus, was effective in decreasing anxiety before SNRB. The present findings suggest that inhalation of 1,8-cineole may be used to relieve anxiety before, during, and after various operations, in addition to SNRB.

The Local Addition of Tenoxicam Reduces the Incidence of Low Back Pain after Lumbar Epidural Anesthesia 

1998 ◽  
Vol 89 (6) ◽  
pp. 1414-1417 ◽  
Author(s):  
Yung-Liang Wang ◽  
Jing-Ru Hsieh ◽  
Ham-See Chung ◽  
Chi-Lun Yu ◽  
Angie C. Y. Ho ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Epidural Anesthesia ◽  
Epidural Needle ◽  
Control Group ◽  
Double Blind Study ◽  
Analog Scale ◽  
Double Blind ◽  
Local Skin ◽  
Skin Infiltration ◽  
Lumbar Epidural Anesthesia

Background Postepidural backache is a common postoperative complaint after lumbar epidural anesthesia. Useful interventions to decrease the incidence of postepidural backache would be helpful. Methods We performed a prospective, randomized, double-blind study to compare the effect of local addition of tenoxicam on the incidence of postepidural backache after nonobstetric surgery. One thousand unpremedicated ASA physical status I or II patients scheduled for hemorrhoidectomy were assigned randomly to tenoxicam or control groups. Patients in the control group received 25 ml lidocaine, 2%, with epinephrine 1:200,000 epidurally and 4 ml lidocaine, 1%, for local skin infiltration. Patients in the tenoxicam group received 25 ml lidocaine, 2%, with epinephrine 1:200,000 epidurally and 4 ml lidocaine, 1%, with tenoxicam (2 mg) 1:2,000 for local skin infiltration. Patients were interviewed at 24, 48, and 72 h postoperatively using a standard visual analog scale for evaluation of postepidural backache. A patient was considered to have postepidural backache when the postoperative visual analog scale score was higher than the preoperative score. Results The incidence of postepidural backache in patients in the control group for the 3 days were 22.8%, 17.4%, and 9.2%, all of which were significantly more frequent than observed in the patients in the tenoxicam group (6.8%, 4.0%, and 1.2%, P &lt; 0.01). There was a significant association between backache and multiple attempts at epidural needle insertion. Conclusion In summary, the local addition of tenoxicam reduced the incidence and severity of postepidural backache.

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