scholarly journals Randomized, controlled trial comparing respiratory and analgesic effects of interscalene, anterior suprascapular, and posterior suprascapular nerve blocks for arthroscopic shoulder surgery

2020 ◽  
Vol 73 (5) ◽  
pp. 408-416 ◽  
Author(s):  
Yean Chin Lim ◽  
Zhao Kun Koo ◽  
Vivian. W. Ho ◽  
See Seong Chang ◽  
Shivani Manohara ◽  
...  
Keyword(s):  
Lung Function ◽  
Controlled Trial ◽  
Suprascapular Nerve ◽  
Forced Expiratory Volume ◽  
Nerve Blocks ◽  
Analgesic Effects ◽  
Pain Scores ◽  
Significant Difference ◽  
Arthroscopic Shoulder Surgery ◽  
Plexus Block

BackgroundInterscalene brachial plexus block (ISB) provides excellent analgesia for arthroscopic shoulder surgeries but is associated with adverse effects including hemidiaphragmatic paresis. We aimed to compare the respiratory effects, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) between suprascapular nerve block (SSB) and ISB.MethodsSixty patients were recruited and randomized into ISB, anterior SSB, and posterior SSB groups. FVC, FEV1, and diaphragmatic excursion were evaluated at baseline and 30 minutes after intervention. Blocks were performed under ultrasound guidance with 15 ml of 0.5% ropivacaine. Pain scores were assessed at 6, 12, and 24 hours postoperatively.ResultsThe ISB group showed a reduced FVC of 31.2% ± 17.5% (mean ± SD), while the anterior and posterior SSB groups had less reduction of 3.6% ± 18.6% and 6.8% ± 6.5%, respectively (P < 0.001). The ISB group showed more reduction in diaphragmatic excursion than the anterior and posterior SSB groups (median [IQR]): −85.7% (−95.3% to −63.3%) vs. −1.8% (−13.1% to 2.3%) and −1.2% (−8.8% to 16.8%), respectively (P < 0.001). The median pain scores (IQR) in the ISB and anterior SSB groups were lower than those in the posterior SSB group at 6 hours on movement: 0 (0–2), 1.8 (0–4.5) vs. 5 (2.5–8), respectively (P = 0.002). There was no significant difference in oxycodone consumption postoperatively.ConclusionsAnterior SSB preserves lung function and has a comparable analgesic effect as ISB. Thus, it is recommended for arthroscopic shoulder surgeries, especially in patients who have reduced lung function.

scholarly journals Effect of mesenchymal stromal cell infusions on lung function in COPD patients with high CRP levels

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daniel J. Weiss ◽  
Karen Segal ◽  
Richard Casaburi ◽  
Jack Hayes ◽  
Donald Tashkin
Keyword(s):  
Lung Function ◽  
Time Course ◽  
Inflammatory Marker ◽  
Controlled Trial ◽  
Phase 1 ◽  
Forced Expiratory Volume ◽  
Allogeneic Mscs ◽  
Copd Exacerbations ◽  
Copd Patients ◽  
Patient Reported

Abstract Background We previously reported a Phase 1/2 randomized placebo-controlled trial of systemic administration of bone marrow-derived allogeneic MSCs (remestemcel-L) in COPD. While safety profile was good, no functional efficacy was observed. However, in view of growing recognition of effects of inflammatory environments on MSC actions we conducted a post-hoc analysis with stratification by baseline levels of a circulating inflammatory marker, C-reactive protein (CRP) to determine the effects of MSC administration in COPD patients with varying circulating CRP levels. Methods Time course of lung function, exercise performance, patient reported responses, and exacerbation frequency following four monthly infusions of remestemcel-L vs. placebo were re-assessed in subgroups based on baseline circulating CRP levels. Results In COPD patients with baseline CRP ≥ 4 mg/L, compared to COPD patients receiving placebo (N = 17), those treated with remestemcel-L (N = 12), demonstrated significant improvements from baseline in forced expiratory volume in one second, forced vital capacity, and six minute walk distance at 120 days with treatment differences evident as early as 10 days after the first infusion. Significant although smaller benefits were also detected in those with CRP levels ≥ 2 or ≥ 3 mg/L. These improvements persisted variably over the 2-year observational period. No significant benefits were observed in patient reported responses or number of COPD exacerbations between treatment groups. Conclusion In an inflammatory environment, defined by elevated circulating CRP, remestemcel-L administration yielded at least transient meaningful pulmonary and functional improvements. These findings warrant further investigation of potential MSC-based therapies in COPD and other inflammatory pulmonary diseases. Trial registration: Clinicaltrials.gov NCT00683722.

scholarly journals Impact of chronic khat (Catha edulis Forsk) chewing on pulmonary function test and oxygen saturation in humans: A comparative study

2019 ◽  
Vol 7 ◽  
pp. 205031211882461 ◽  
Author(s):  
Gashaw Garedew Woldeamanuel ◽  
Teshome Gensa Geta
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Oxygen Saturation ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Mean Values ◽  
Khat Chewing ◽  
Significant Difference ◽  
The Mean

Background: Chronic consumption of khat affects many organ systems and leads to various health disturbances in the chewers. Few studies examined the acute effects of khat ingestion on lung function parameters. However, studies which assessed the long-term effects of khat chewing on pulmonary function parameters and oxygen saturation are lacking. Objective: The aim of this study was to assess the impact of chronic Khat chewing on pulmonary function parameters and oxygen saturation among chronic Khat chewers in Wolkite, Ethiopia. Methods: A community-based comparative cross-sectional study was conducted in Wolkite, Ethiopia from 1 June 2018 to 15 August 2018. A total of 324 participants, 162 khat chewers and 162 non-chewers were included in the study. The data were collected through face-to-face interview by trained data collectors. British Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A spirometer was used to assess various lung function parameters. Moreover, oxygen saturation of hemoglobin was measured using pulse oximeter. Data were entered into CSPro version 6.2 and analyzed using SPSS version 23. Results: This study showed statistically significant (p < 0.05) reduction in the mean values of forced vital capacity, forced expiratory volume in first second and maximum ventilation volume among khat chewers as compared to non-chewers. There was no significant difference in the mean values of other lung function parameters between the two groups. Similarly, there was no significant difference (p = 0.642) in mean oxygen saturation of hemoglobin (SaO2) across the two groups. Conclusion: It is evident from this study that long-term khat consumption is associated with decreased mean forced vital capacity, forced expiratory volume in first second and maximum ventilation volume. Hence, there is a need for further study to strengthen the current findings and to explore the mechanisms of khat chewing effect on lung function parameters.

scholarly journals Effect of Chinese Propolis as an Intracanal Medicament on Post-Operative Endodontic Pain: A Double-Blind Randomized Controlled Trial

2020 ◽  
Vol 17 (2) ◽  
pp. 445 ◽  
Author(s):  
Juzer Shabbir ◽  
Fazal Qazi ◽  
Waqas Farooqui ◽  
Shahbaz Ahmed ◽  
Tazeen Zehra ◽  
...  
Keyword(s):  
Calcium Hydroxide ◽  
Controlled Trial ◽  
Repeated Measure ◽  
P Value ◽  
Time Intervals ◽  
Pain Scores ◽  
Significant Difference ◽  
Bonferroni Test ◽  
The Impact ◽  
Chinese Propolis

Propolis is a potent anti-microbial and natural anti-inflammatory by-product obtained from the beehive. Studies have demonstrated the superior biocompatibility and anti-microbial properties of propolis as compared to calcium hydroxide. However, its effect on postoperative endodontic pain is unknown. Therefore, this study aimed to investigate the impact of Chinese propolis paste as an intracanal medicament on postoperative endodontic pain intensities compared with calcium hydroxide (control) at different time intervals in necrotic teeth with periapical radiolucency. Eighty patients with single-rooted necrotic teeth with visible periapical radiolucency were recruited and randomly allocated to either the calcium hydroxide or propolis groups. After chemo-mechanical preparation and intracanal medicament insertion, patients were given the VAS (visual analogue scale) to record pain scores. Inter-group data were compared and analyzed using two-way repeated measure ANOVA (Bonferroni test). A p-value of < 0.025 was considered significant. In total, >78% of the patients experienced no or only mild post-operative pain in both the groups at all time intervals, without any significant difference in pain scores between the two groups (p > 0.025). An overall flare-up rate of 14.8% was found. The results suggest that either of these medicaments can be used as an inter-appointment medication for the prevention of postoperative pain in necrotic cases.

Randomized comparison between interscalene and costoclavicular blocks for arthroscopic shoulder surgery

2019 ◽  
Vol 44 (4) ◽  
pp. 472-477 ◽  
Author(s):  
Julián Aliste ◽  
Daniela Bravo ◽  
Sebastián Layera ◽  
Diego Fernández ◽  
Álvaro Jara ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Onset Time ◽  
Suprascapular Nerve ◽  
Axillary Nerve ◽  
Shoulder Surgery ◽  
Sensory Function ◽  
Ultrasound Guided ◽  
Pain Scores ◽  
Arthroscopic Shoulder Surgery

BackgroundThis randomized trial compared ultrasound-guided interscalene block (ISB) and costoclavicular brachial plexus block (CCB) for arthroscopic shoulder surgery. We hypothesized that CCB would provide equivalent analgesia to ISB 30 min after surgery without the risk of hemidiaphragmatic paralysis.MethodsAll 44 patients received an ultrasound-guided block of the intermediate cervical plexus. Subsequently, they were randomized to ISB or CCB. The local anesthetic agent (20 mL of levobupivacaine 0.5% and epinephrine 5 µg/mL) and pharmacological block adjunct (4 mg of intravenous dexamethasone) were identical for all study participants. After the block performance, a blinded investigator assessed ISBs and CCBs every 5 min until 30 min using a composite scale that encompassed the sensory function of the supraclavicular nerves, the sensorimotor function of the axillary nerve and the motor function of the suprascapular nerve. A complete block was defined as one displaying a minimal score of six points (out of a maximum of eight points) at 30 min. Onset time was defined as the time required to reach the six-point minimal composite score. The blinded investigator also assessed the presence of hemidiaphragmatic paralysis at 30 min with ultrasonography.Subsequently, all patients underwent general anesthesia. Postoperatively, a blinded investigator recorded pain scores at rest at 0.5, 1, 2, 3, 6, 12, and 24 hours. Patient satisfaction at 24 hours, consumption of intraoperative and postoperative narcotics, and opioid-related side effects (eg, nausea/vomiting, pruritus) were also tabulated.ResultsBoth groups displayed equivalent postoperative pain scores at 0.5, 1, 2, 3, 6, 12, and 24 hours. ISB resulted in a higher incidence of hemidiaphragmatic paralysis (100% vs 0%; P < 0.001) as well as a shorter onset time (14.0 (5.0) vs 21.6 (6.4) minutes; p<0.001). However, no intergroup differences were found in terms of proportion of patients with minimal composite scores of 6 points at 30 min, intraoperative/postoperative opioid consumption, side effects, and patient satisfaction at 24 hours.ConclusionCompared to ISB, CCB results in equivalent postoperative analgesia while circumventing the risk of hemidiaphragmatic paralysis. Further confirmatory trials are required. Future studies should also investigate if CCB can provide surgical anesthesia for arthroscopic shoulder surgery.Clinical Trials RegistrationNCT03411343.

scholarly journals COMPARISON OF FENTANYL AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMIZED-DOUBLE BLIND PROSPECTIVE STUDY

2016 ◽  
Vol 9 (5) ◽  
pp. 74 ◽  
Author(s):  
Daisy Karan ◽  
Swastika Swaro ◽  
Swarna Banerjee
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Nerve Blocks ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACTObjectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Using adjuvant to localanesthetics, blocks can be prolonged to long durations. Peripheral nerve blocks thus help in avoiding the hazards of general anesthesia. We comparedthe sensory blockade, motor blockade, and duration of analgesia with the addition of fentanyl or dexmedetomidine to bupivacaine for supraclavicularbrachial plexus block.Methods: A total of 50 American Society of Anesthesiologist’s Physical Status I and II patients scheduled for elective upper limb surgeries undersupraclavicular brachial plexus block were divided into two equal groups in a randomized double-blinded fashion. Group BF received 30 mlbupivacaine with fentanyl 50 µg and Group BD received 30 ml bupivacaine with dexmedetomidine 50 µg. The characteristics for anesthesia andanalgesia were assessed in both groups.Results: Duration of sensory and motor block was 363.4±38.36 minutes and 357±36.77 minutes, respectively, in Group BF while it was452.96±77.12 minutes and 441.52±48.46 minutes in Group BD. There was a statistically significant difference in onset of sensory and motorblock between the two groups. The duration of analgesia (time to requirement of rescue analgesia) in Group BD was longer than in Group BF(471.44±65.88 minutes vs. 366.48±38.02 minutes) with (p<0.0001). There were minimum hemodynamic disturbances and side effects in any groupexcept for Grade 3 sedation score which was more in Group BD.Conclusion: Dexmedetomidine, when added to bupivacaine in supraclavicular brachial plexus block, enhanced the duration of sensory and motorblock and also the duration of analgesia, more than when fentanyl was added to bupivacaine.Keywords: Fentanyl, Dexmedetomidine, Bupivacaine, Supraclavicular brachial block.

scholarly journals Lung function test in children with left-to-right shunt congenital heart disease

2018 ◽  
Vol 58 (4) ◽  
pp. 165-9
Author(s):  
Carolina Kurniawan ◽  
Indah Kartika Murni ◽  
Sasmito Nugroho ◽  
Noormanto Noormanto ◽  
Roni Naning
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Lung Function ◽  
Congenital Heart ◽  
Vital Capacity ◽  
Septal Defect ◽  
Forced Expiratory Volume ◽  
Significant Difference ◽  
Restrictive Lung Function

Background Increased pulmonary blood flow may lead to abnormal lung function in children with left-to-right (L to R) shunt congenital heart disease. This condition has been linked to considerable mortality and morbidity, including reduced lung function. Objective To assess for lung function abnormality in children with L to R shunt congenital heart disease. Methods We conducted a cross-sectional study involving children aged 5-18 years and diagnosed with L to R shunt congenital heart disease at Dr. Sardjito Hospital from March to May 2017. Subjects underwent spirometry tests to measure forced expiratory volume-1 (FEV-1), forced vital capacity (FVC), and forced expiratory volume-1 (FEV-1)/forced vital capacity (FVC). Results Of 61 eligible subjects, 30 (49.2%) children had atrial septal defect (ASD), 25 (41%) children had ventricular septal defect (VSD), and 6 (9.8%) children had patent ductus arteriosus (PDA). Spirometry revealed lung function abnormalities in 37 (60.7%) children. Restrictive lung function was documented in 21/37 children, obstructive lung function in 11/37 children, and mixed pattern of lung function abnormality in 5/37 children. Pulmonary hypertension was found in 21 children. There was no significant difference in lung function among children with and without pulmonary hypertension (P=0.072). Conclusion Abnormal lung function is prevalent in 60.7% of children with L to R shunt congenital heart disease, of which restrictive lung function is the most common. There was no significant difference in lung function among children with and without pulmonary hypertension.

scholarly journals Pulmonary function deficits in newborn screened infants with cystic fibrosis managed with standard UK care are mild and transient

2017 ◽  
Vol 50 (5) ◽  
pp. 1700326 ◽  
Author(s):  
Gwyneth Davies ◽  
Janet Stocks ◽  
Lena P. Thia ◽  
Ah-Fong Hoo ◽  
Andrew Bush ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Early Life ◽  
Treatment Protocol ◽  
Forced Expiratory Volume ◽  
Z Score ◽  
Average Group ◽  
Significant Difference ◽  
Residual Capacity ◽  
High Risk Infants

With the advent of novel designer molecules for cystic fibrosis (CF) treatment, there is huge need for early-life clinical trial outcomes, such as infant lung function (ILF). We investigated the degree and tracking of ILF abnormality during the first 2 years of life in CF newborn screened infants.Forced expiratory volume in 0.5 s (FEV0.5), lung clearance index (LCI) and plethysmographic functional residual capacity were measured at ∼3 months, 1 year and 2 years in 62 infants with CF and 34 controls.By 2 years there was no significant difference in FEV0.5 z-score between CF and controls, whereas mean LCI z-score was 0.81 (95% CI 0.45–1.17) higher in CF. However, there was no significant association between LCI z-score at 2 years with either 3-month or 1-year results. Despite minimal average group changes in any ILF outcome during the second year of life, marked within-subject changes occurred. No child had abnormal LCI or FEV0.5 on all test occasions, precluding the ability to identify “high-risk” infants in early life.In conclusion, changes in lung function are mild and transient during the first 2 years of life in newborn screened infants with CF when managed according to a standardised UK treatment protocol. Their potential role in tracking disease to later childhood will be ascertained by ongoing follow-up.

scholarly journals Perbandingan FEV1 antara subjek perokok dan non perokok pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Manado

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Maniata F. Bata ◽  
Maarthen C.P. Wongkar ◽  
Bisuk P. Sedli
Keyword(s):  
Medical Students ◽  
Lung Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Study Data ◽  
T Test ◽  
F Test ◽  
Anova Test ◽  
Significant Difference

Abstract: Smoking is one of the factors causing decline of lung function characterized by impairment of Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), and FEV1/FVC. This study was aimed to obtain the differences in FEV1 between smokers and non smokers, among smokers based on duration of smoking, and among smokers based on the number of cigarettes per day in medical students of University of Sam Ratulangi Manado. This was an observational analytic study. Data were analyzed by using the independent T test and the ANOVA with the F Test. Subjects were 40 males, consisted of 20 smokers and 20 non-smokers. Six smokers had smoked for 2-5 years and 14 smokers had smoked for >5 years. Smoking less than10 cigarettes/day, 10-20 cigarettes/day, and more than 20 cigarettes/day were found in 8, 9, and 3 subjects respectively. The independent T-test showed that there was no significant difference in FEV1 between smokers and non-smokers (p=0.250). The independent T-test also showed that there was no significant difference in FEV1 between smokers of 2-5 years and smokers of more than 5 years (p=0.117). The ANOVA test showed that there was no significant difference in FEV1 between smokers of <10 cigarettes/day, 10-20 cigarettes/day, and >20 cigarettes/day (p=0.481). Conclusion: In this study there were no significant differences in FEV1 between smokers and non smokers, among smokers based on duration of smoking, and among smokers based on the number of cigarettes per day.Keywords: smoker, non smoker, FEV1, duration of smoking, number of cigarette Abstrak: Merokok adalah salah satu faktor penyebab penurunan fungsi paru yang ditandai oleh penurunan nilai volume Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), dan rasio FEV1/FVC. Penelitian ini bertujuan untuk mengetahui perbedaan FEV1 antara subjek perokok dan non perokok, antar subjek perokok berdasarkan lama merokok, dan antar subjek perokok berdasarkan jumlah batang rokok yang dihisap per hari pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi. Jenis penelitian ialah observasional analitik dengan uji T independent dan uji ANOVA dengan uji F. Subjek penelitian ialah 40 orang laki-laki terdiri dari 20 subjek perokok dan 20 subjek non perokok. Hasil penelitian mendapatkan terdapat 6 subjek perokok yang telah merokok selama 2-5 tahun dan 14 subjek telah merokok selama >5 tahun sedangkan yang menghisap rokok <10 batang/hari, 10-20 batang/hari, dan >20 batang/hari ialah masing-masing 8 orang, 9 orang, dan 3 orang. Uji T-independent menunjukkan tidak terdapat perbedaan bermakna antara FEV1 subjek perokok dan non perokok (p=0,250). Hasil uji T independent terhadap perbedaan FEV1 subjek perokok yang telah merokok 2-5 tahun dengan yang telah merokok >5 tahun mendapatkan p=0,117. Uji ANOVA terhadap perbedaan nilai FEV1 antara subjek perokok yang menghisap rokok sebanyak <10 batang/hari, 10-20 batang/hari, dan >20 batang/hari mendapatkan p=0,481. Simpulan: Pada penelitian ini tidak terdapat perbedaan bermakna antara FEV1 subjek perokok dan non perokok, antar subjek perokok berdasarkan lama merokok, dan antar subjek perokok berdasarkan jumlah batang rokok yang dihisap per hari.Kata kunci: perokok, non perokok, FEV1, lama merokok, jumlah batang rokok

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