scholarly journals Features of prophylactic treatment in patients with different forms of migraine, complicated by migraine status

2021 ◽  
pp. 33-36
Author(s):  
I. P. Didkova

The purpose of this study was to study the dynamics of indicators of the scale of Migraine Disability Assessment (MIDAS) in patients with different forms of migraine, which is complicated by migraine status due to the use of prophylactic treatment. 50 patients suffering from migraine, complicated by migraine status, have been examined and treated in the neurological department of the Kyiv Railway Clinical Hospital №2. The degree of pain has been assessed on a visual analog scale (VAS) and the level of disability has been assessed on MIDAS. The solution of valproate acid was used in the main group of patients for the treatment of migraine status during three days. The traditional vasoactive and dehydration therapy was used in the control group within ten days. It was proved, that the solution of preparation of valproic acid for treatment of status migrainous authentically increases degree of headache and level of disadaptation in patients during 6 months. Migraine attacks continued to lead to loss of working capacity and daily activity of patients in the control group. Treatment was safe for patients and well tolerated.Our study showed that the use of solution of valproate acid in the treatment of migraine status in patients with different forms of migraine is authentic effective and leads to decrease the degree of disadaptation in patients during 6–8 months after treatment.

2020 ◽  
Vol 50 (1) ◽  
pp. 38
Author(s):  
Ade Asyari ◽  
Novialdi Novialdi ◽  
Elniza Morina ◽  
Rimelda Aquinas ◽  
Nasman Puar ◽  
...  

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.


2020 ◽  
Author(s):  
Yang Lu ◽  
Peng Mao ◽  
Guihuai Wang ◽  
Wei Tao ◽  
Donglin Xiong ◽  
...  

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


2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Wiwit Sugiarti ◽  
Sri Nabawiyati Nurul Makiyah ◽  
Azizah Khoiriyati

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


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

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.


2015 ◽  
Vol 50 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Emily A. Hall ◽  
Carrie L. Docherty ◽  
Janet Simon ◽  
Jackie J. Kingma ◽  
Joanne C. Klossner

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.


2015 ◽  
Vol 1 (1) ◽  
pp. 13-17
Author(s):  
Rupesh Kumar Gami ◽  
Kumar Jahan ◽  
Chandra Bhushan Jha

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


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ka Young Kim ◽  
Hyo Jin Seo ◽  
Sun Seek Min ◽  
Mira Park ◽  
Geun Hee Seol

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.


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 ◽  
...  

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.


2019 ◽  
Vol 18 (8) ◽  
pp. 651-657 ◽  
Author(s):  
Kamile Akarsu ◽  
Ayşegül Koç ◽  
Nurcan Ertuğ

Background: Percutaneous coronary interventions cause anxiety in patients, although these procedures are lifesaving. Aim: The aim of this study was to determine the effect of nature sounds and earplug interventions on the anxiety of patients after percutaneous coronary interventions. Methods: A randomized controlled trial design was used in this study. A total of 114 patients who were scheduled to undergo percutaneous coronary intervention were allocated to three groups in a randomized manner: two intervention groups (nature sound group, earplug group) and one control group. The Visual Analog Scale, State Anxiety Inventory and physiological parameters were used to measure anxiety. Data were collected from the patients at three time points: immediately before, immediately after and 30 minutes after the interventions. Results: The respiratory rates and the Visual Analog Scale and State Anxiety Inventory scores of patients in the nature sound and earplug groups immediately after and 30 minutes after the interventions were significantly lower than those of the control group ( p < 0.05). No differences were found when comparing respiratory rates, Visual Analog Scale scores and State Anxiety Inventory scores between patients in the nature sound group and patients in the earplug group ( p > 0.05). No changes were observed in the pulse and systolic/diastolic blood pressure values of patients in the control and intervention groups ( p > 0.05). Conclusions: It was determined that nature sounds and earplug interventions are effective in reducing the anxiety of patients following percutaneous coronary intervention.


Author(s):  
ALESSA FAHIRA ◽  
ALLYSA SORAYA ◽  
ARMAND ACHMADSYAH ◽  
RANI WARDANI HAKIM

Objective: Osteoarthritis (OA) is a chronic disease caused by inflammation of the tissue and bony structure of the joint, which affects more than 235 million people worldwide. Due to the adverse effects caused by the long-term use of standard treatment of OA, the attempt to find natural remedies to treat chronic diseases continues to rise. Curcuma longa is known to have anti-inflammatory effects, which may impact the pathophysiology of OA. While many randomized controlled trials show the efficacy of Curcuma longa extract in the treatment of OA, there has been no comprehensive review of this evidence. Methods: We systematically searched PubMed, Cochrane, Scopus, ProQuest, EBSCOhost, and ScienceDirect for randomized controlled trials that evaluated Curcuma longa extract (CE extract) vs. control (placebo or other therapy). Three trials were identified. Data were then extracted from the studies and summarized descriptively. Results: Across all trials, Curcuma longa therapy was proven to reduce Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores significantly compared to the control group. Adverse effects were less likely to appear in patients treated with Curcuma longa extract compared to other groups. Conclusion: CL extract is beneficial as an alternative medication for OA treatment, shown by the reduced scores of the Visual Analog Scale (VAS) and WOMAC in all studies we reviewed.


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