scholarly journals A comparative evaluation of the effects on postoperative pain of systemic and topical forms of benzydamine hydrochloride after periodontal flap surgery: A randomized controlled clinical trial

2020 ◽  
Vol 7 (2) ◽  
pp. 394-399
Author(s):  
Gülhan Kocaman
Keyword(s):  
Postoperative Pain ◽  
Topical Application ◽  
Pain Control ◽  
Double Blind Study ◽  
Clinical Parameters ◽  
Flap Surgery ◽  
Postoperative Pain Control ◽  
Significant Difference ◽  
Spray Form ◽  
Periodontal Flap Surgery

Objective:  The aim of this study was to evaluate comparatively the topical and systemic forms in the postoperative pain control periodontal flap surgery in spite of the daily dose of benzydamine hydrochloride spray form about one in twenty of the oral dose,. Materials and Methods: In this randomized trial, the 48 systemic healthy individuals in need double-blind study with periodontal flap surgery were evaluated. Consent, demographic information and periodontal clinical parameters were obtained before surgery and periodontal flap surgery was performed with local anesthesia. The patients who underwent surgery were randomly assigned to two groups. One of the groups was prescribed tablet form of postopertive benzydamine hydrochloride and for the other was spray form as topical application. Postoperative pain was assessed by visual analog scale at 2, 6, 8, 12, 24 and 48 hours. Results: There was no difference between systemic and topical drug groups in terms of demographic characteristics and periodontal clinical parameters. A statistically significant difference was found between 2 and 6 hours in favor of topical application. (p <0.05), but there was no significant difference in pain intensity at the 8th, 12th, 24th and 48th hours. Conclusion: Although the topical form of benzydamine hydrochloride was 1/20 lower in postoperative pain control after periodontal flap surgery, it was found to be more effective in the early period compared to the systemic form, but equally effective in the late period. We premierly recommend that topical application should be preferred primarily in the prevention of overdose and toxicity in postoperative pain control after periodontal flap operation.

scholarly journals Microbial Adherence of three different suture materials in patients undergoing periodontal flap surgery. A clinical & microbiological study

2020 ◽  
Vol 6 (2) ◽  
pp. 28-32
Author(s):  
Pranav Kumar Singh ◽  
Sarita Joshi Narayan ◽  
TV Narayan ◽  
Umesh Yadalam ◽  
Vijay Raghava ◽  
...  
Keyword(s):  
Microbial Colonization ◽  
Base Line ◽  
Clinical Parameters ◽  
Flap Surgery ◽  
Suture Materials ◽  
Bleeding On Probing ◽  
Significant Difference ◽  
Vicryl Suture ◽  
Micro Organisms ◽  
Periodontal Flap Surgery

proliferation of microbes to the parts open to the oral cavity. Hence, microbial colonization on various intraoral suture materials from patients undergoing periodontal flap surgery and its impact on healing of gingival tissues was compared. Patients and Methods: During periodontal flap surgery, three different suture materials (silk, polyamide, & vicryl) were used in 25 patients. Eight days postoperatively, the sutures were removed, and adhered micro-organisms were counted by culturing on nutrient agar. Additionally clinical parameters, bleeding on probing and papillary position to assess healing were recorded to baseline, at 2 weeks, 4 weeks, and 6 weeks. Wilcoxon signed ranks test was used for statistical analysis. Results: Mean CFU’s for silk, polyamide and vicryl sutures were 6.239 ±1.476 X 108, 2.425 ± 1.010 X 108, 4.431 ± 1.069 X 108. There was no inter-group statistical difference in the clinical parameters i.e. bleeding on probing, papillary position at all time periods (p>0.05). There was a significant statistical improvement in bleeding on probing in all the three groups from base line (p<0.05). Conclusions: The results of the present study demonstrated that bacteria have different affinity towards different suture materials. Monofilament polyamide suture adhered the least amount of bacteria, followed by multifilament vicryl suture, while silk adhered maximum amount of bacteria. There was no statistically significant difference in the healing of gingival tissues in between all the three groups. Keywords: Monofilament sutures, Multifilament sutures, Colony forming units, Periodontal flap surgery  

scholarly journals Comparison of Efficacy of Pain Control Using the Interseptal Injection Technique and Inferior Alveolar Block Accompanied by Long Buccal Infiltration in Mandibular Periodontal Flap Surgery

2018 ◽  
Vol 6 (1) ◽  
pp. 8-12
Author(s):  
Mohammad Taghi Chitsazi ◽  
Reza Pourabbas ◽  
Adileh Shirmohammadi ◽  
Saied Nezafati ◽  
Amin Mousavi
Keyword(s):  
Pain Control ◽  
Statistical Significance ◽  
Inferior Alveolar Nerve ◽  
Anesthetic Technique ◽  
Flap Surgery ◽  
Pain Scores ◽  
Significant Difference ◽  
To Receive ◽  
Buccal Infiltration ◽  
Periodontal Flap Surgery

Background and aims. Pain control ensures patient satisfaction and cooperation. This study aimed to compare the interseptal anesthetic technique (IA) as the initial injection for pain control during periodontal flap surgery with the inferior alveolar nerve block (IANB) accompanied by long buccal infiltration (LBI). Materials and methods. This single-blind randomized clinical trial included 40 periodontitis patients. Pain intensity was evaluated immediately after injection and at the end of surgery. One side was chosen as the control to receive IANB accompanied by LBI and the other side as the test to receive IA. After the injection, the patients were asked to mark their reaction to the pain immediately after the injection on a visual analogue scale, which was repeated to analyze pain the day after surgery. Data were analyzed with independent-samples t-test using SPSS 13. Statistical significance was set at P < 0.05. Results. The mean pain scores immediately after injection in the control and test groups were 20.62 ± 7.62 and 21.47 ± 8.62, respectively, with no statistically significant difference (df = 78, t = −0.466, P = 0.642). Pain scores 24 hours after completion of surgery in the control and test groups were 7.97 ± 3.43, and 9.30 ± 3.24, respectively, with no significant difference (df = 78, t = −1.775, P = 0.080). Conclusion. Based on the results, interseptal anesthetic technique was not shown to be superior to conventional injections.

scholarly journals Bayesian inference for causal mechanisms with application to a randomized study for postoperative pain control

Biostatistics ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 605-617 ◽  
Author(s):  
Michela Baccini ◽  
Alessandra Mattei ◽  
Fabrizia Mealli
Keyword(s):  
Postoperative Pain ◽  
Mediation Analysis ◽  
Pain Control ◽  
Randomized Study ◽  
Double Blind Study ◽  
Principal Stratification ◽  
Self Administration ◽  
Postoperative Pain Control ◽  
Double Blind ◽  
Effect Of Treatment

SUMMARY We conduct principal stratification and mediation analysis to investigate to what extent the positive overall effect of treatment on postoperative pain control is mediated by postoperative self administration of intra-venous analgesia by patients in a prospective, randomized, double-blind study. Using the Bayesian approach for inference, we estimate both associative and dissociative principal strata effects arising in principal stratification, as well as natural effects from mediation analysis. We highlight that principal stratification and mediation analysis focus on different causal estimands, answer different causal questions, and involve different sets of structural assumptions.

scholarly journals Comparison of Intercostal Nerve Block with Ropivacaine and Ropivacaine-Dexmedetomidine for Postoperative Pain Control in Patients Undergoing Thoracotomy: A Randomized Clinical Trial

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Kamran Mahmoudi ◽  
Mahboobeh Rashidi ◽  
Farhad Soltani ◽  
Mohsen Savaie ◽  
Ehsan Hedayati ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Randomized Clinical Trial ◽  
Pain Control ◽  
Opioid Consumption ◽  
Postoperative Pain Control ◽  
Rescue Analgesia ◽  
Number Of Patients ◽  
Significant Difference ◽  
Intercostal Block

Background: Thoracotomy is one of the most painful surgeries, and failure to alleviate patients' pain can have dangerous consequences. Objectives: This study aimed to evaluate the addition of dexmedetomidine to ropivacaine in the intercostal block for postoperative pain control in patients undergoing thoracotomy. Methods: In this randomized clinical trial, 74 patients aged 18 to 60 years with ASA class I or II, BMI less than 40, and no severe systemic problems referred to a teaching hospital in Ahvaz to undergo thoracotomy were included in the study and randomly divided into two groups. After surgery, an ultrasound-guided intercostal block was done with ropivacaine (5 cc of 0.25% solution; group R) or ropivacaine (5 cc of 0.25% solution) plus dexmedetomidine (0.5 µg/kg; group RD) per dermatome. Two dermatomes above and two dermatomes below the level of surgical incision were used. Pain, total opioid consumption, length of ICU stays, time to first rescue analgesic, and time to get out of bed were compared between the two groups. Results: The intercostal block significantly reduced pain in both groups (P < 0.0001). The pain was lower in the RD group than in the R group from six hours after the intervention up to 24 hours after (P < 0.001). The number of patients who needed rescue analgesia at 12 hours was significantly lower in the RD group (P < 0.05). The RD group also had lower total opioid consumption and a longer time to receive the first rescue analgesia (P < 0.01). There was no significant difference between the two groups in the length of hospitalization and the time to get out of bed. Conclusions: Dexmedetomidine is an effective and safe choice to be used as an adjunct to ropivacaine in ICB, and it extends the duration of analgesia in combination with ropivacaine after thoracotomy.

scholarly journals Efficacy of Duloxetine Compared with Opioid for Postoperative Pain Control Following Total Knee Arthroplasty

2020 ◽  
Author(s):  
Man Soo Kim ◽  
In Jun Koh ◽  
Keun Young Choi ◽  
Sung Cheol Yang ◽  
Yong In
Keyword(s):  
Total Knee Arthroplasty ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Control ◽  
Readmission Rate ◽  
Womac Score ◽  
Postoperative Pain Control ◽  
Vas Score ◽  
Significant Difference ◽  
Total Knee

Abstract BackgroundOpioid is known to be effective in pain control after total knee arthroplasty (TKA). However, recently it has become a major concern due to addiction. Duloxetine, the serotonin-norepinephrine reuptake inhibitor, is effective for pain control in osteoarthritis patients. However, no study has compared the efficacy of the two for pain control after TKA. The purpose of this study was to assess the efficacy of duloxetine as an alternative to opioid treatment for postoperative pain management following TKA.MethodsAmong 857 patients, 260 (30.3%) of patients received opioid or duloxetine for pain control for 6 weeks when the pain Visual Analogue Scale (VAS) score was greater than 4 out of 10 at the time of discharge. 121 patients in the Opioid group and 118 in the Duloxetine group were followed up for more than one year. Preoperative and postoperative patient reported outcome measures (pain VAS score, Western Ontario and McMaster Universities OA Index (WOMAC) score, and the rate over the minimum clinically significant difference (MCID) using WOMAC score) were compared. The rate of further drug prescription (opioid or duloxetine) after 6 weeks of first prescription, 30-day readmission rate, and side effects were also investigated.ResultsThere was no significant difference in pain VAS score, WOMAC Pain and Function score, or the rate over MCID at each time point between before and after surgery (all p > 0.05). Fifteen (11.0%) patients in the opioid group and six (4.8%) patients in the duloxetine group were prescribed additional medication after first 6 weeks, showing no significant (p > 0.05) difference in proportion. The 30-day readmission rate and the incidence of side effects were also similar (all p > 0.05).ConclusionDuloxetine has a similar effect to opioid on postoperative pain control. Thus, duloxetine can be considered as an alternative to opioid for postoperative pain control following TKA.Level of evidence:Therapeutic study Level Ⅳ.

Effect of Magnesium Sulfate on the Total Anesthetic and Analgesic Requirements in Neurosurgery

2021 ◽  
pp. 27-28
Author(s):  
Essam Manaa
Keyword(s):  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Recovery Time ◽  
Control Group ◽  
Double Blind Study ◽  
Clinical Parameters ◽  
Hemodynamic Parameters ◽  
Analgesic Requirement ◽  
Group I ◽  
Significant Difference

Introduction: The intraoperative anesthetic and postoperative analgesic requirements are of great importance especially in neurosurgical anesthesia. This requires balancing a deep and effective anesthesia and postoperative analgesia versus the risks of delayed recovery and postoperative respiratory depression from excessive analgesics. Magnesium sulfate is an antagonist of the N-Methyl-D-Aspartate (NMDA) receptors in a voltage-dependent fashion. Propofol also inhibits the NMDA subtype of the glutamate receptor. Therefore, magnesium sulfate when coadministered with propofol potentiates anesthetic effect and NMDA antagonism of propofol. Majority of the studies that evaluated the anesthetic and analgesic requirement in patients receiving magnesium sulfate depended on the clinical parameters, for example, hemodynamic parameters and measurement of pain scores. In this study, we added bispectral index (BIS) and neuromuscular monitoring using train-of-four (TOF) to adjust intraoperative anesthetic requirements in addition to the clinical parameters. Methodology: This randomized controlled double-blind study included 50 adult ASA I and II male and female patients undergoing neurosurgical maneuvers. Patients were randomly divided into two equal groups. Routine intraoperative monitoring including invasive BP and in addition TOF and BIS were applied. In a blind fashion, patient in group I (Magnesium group) received magnesium sulfate 20 mg/kg as bolus dose over 5 min followed by 0.1 ml/kg/hr of 10% solution as infusion, while patient in group II (Control group) received saline with the same bolus and infusion rates after the induction of anesthesia. Anesthesia was induced in both groups by fentanyl 2 µg/kg, propofol 1.5–2 mg/kg, and rocuronium in a dose of 0.6 mg/kg to facilitate ETT insertion. This is followed by continuous infusion of propofol 6–10 mg/kg/hr and fentanyl 1–2 mic/kg/hr. The parameters which were assessed included hemodynamic parameters (HR and BP), TOF, and BIS. Total consumptions of propofol, fentanyl, rocuronium, and postoperative analgesic requirements (PCA morphine) were recorded. In addition, recovery time and postoperative pain score by visual analog scale (VAS) were recorded. Result: There was no significant difference in patient characteristics between the two groups. As regard the hemodynamic changes and BIS, no significant difference was seen between the two groups except the HR change which was significantly reduced (p = 0.005) with surgical stimulation in group I compared to the other group. Results also showed that the mean fentanyl, propofol, and rocuronium consumption, recovery time, degree of postoperative pain, and postoperative analgesic requirements were significantly less in patients that received magnesium sulfate infusion compared to those in the control group. Conclusion: Magnesium sulfate is most likely a safe and cost-effective supplement to the general anesthesia in neurosurgery as it reduces the total anesthetic and analgesic requirements and postoperative pain.

Written Prescription for Over-the-Counter Nonopioid Pain Medications Does Not Increase the Likelihood of Use after Ambulatory Hand and Upper Extremity Surgery

2020 ◽  
Author(s):  
Daniel J. Lynch ◽  
James S. Lin ◽  
Kanu S. Goyal
Keyword(s):  
Postoperative Pain ◽  
Soft Tissue ◽  
Upper Extremity ◽  
Pain Control ◽  
Control Program ◽  
Postoperative Pain Control ◽  
Over The Counter ◽  
Unequal Variance ◽  
Pain Medications ◽  
Medication Consumption

Abstract Introduction This study looked to determine how providing written prescriptions of nonopioids affected postoperative pain medication usage and pain control. Materials and Methods Patients undergoing hand and upper-extremity surgery (n = 244) were recruited after the implementation of a postoperative pain control program encouraging nonopioids before opioids. Patients were grouped based on procedure type: bone (n = 66) or soft tissue (n = 178). Patients reported postoperative medication consumption and pain control scores. Two-tailed t-tests assuming unequal variance were performed to look for differences in postoperative pain control and medication consumption between those who were and were not given written prescriptions for nonopioids. Results For both soft tissue and bone procedure patients, a written prescription did not significantly affect patients’ postoperative pain control or medication consumption. Regardless of receiving a written prescription, patients who underwent soft tissue procedures consumed significantly more daily nonopioids than opioids. Conclusion Receiving written prescriptions for nonopioids may not have a significant effect on postoperative pain control or medication consumption. Patients undergoing soft tissue hand and upper extremity procedures may be more likely to consume more daily nonopioids than opioids postoperatively compared to bone procedure patients regardless of whether they receive a written prescription for nonopioids.

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