scholarly journals Comparison Between Paracetamol Vs Voltral Suppositories For Post Operative Pain In Gynaecological Procedure

Esculapio ◽  
2021 ◽  
Vol 17 (2) ◽  
pp. 191-194
Author(s):  
Zeeshan Khan ◽  
Saadia Khaleeq ◽  
Abaid ur Rehman ◽  
Aasam Maan ◽  
Umer Farooq ◽  
...  

Objective: To compare intravenous paracetamol vs Voltral (Diclofenac) suppositories for post operative pain in gynaecological procedures. Methods: This was a non randomized controlled trial that was carried out at Department of Anaesthesiology, Sheikh Zayed Hospital, Rahim Yar Khan during 01-07-2019 to 31-12-2019 in which all female cases with age range of 20 to 60 year undergoing any gynaecological surgery requiring general anaesthesia were included. The cases were divided into two equal groups and anesthesia was offered in standard doses. Just before reversal the cases in group Awere given intravenous paracetamol in a dose of 1 gm stat and then at 8-hour interval and those in group B were offered diclofenac suppositories in a dose of 50 mg twice a day, 12 hours apart. The pain was assessed at 4,8,12 and 24 hours and was labelled on visual analogue scale (VAS). Results: In this study there were 62 cases (31 in each group). The mean age in group A and B was 45.41±10.21 vs 48.12±11.13 years with p= 0.47. Mean duration of surgery in both groups was 57.51±15.23 vs53.11±14.79 minutes with p= 0.81. There was no significant difference in mean pain score at 4 and 8 hours with p= 0.91 and 0.81 respectively in group A and B. Mean pain score was 4.43±1.67 vs 3.21±1.09 with p= 0.01 at 12 and 4.57±1.71 vs 3.34±1.27 at 24 hours in group A and B with p values of 0.01 each. Mean time taken for rescue analgesia was 9.13±2.11 in group Aand 13.11±1.23 hours in group B with p= 0.001. Conclusion: Voltral (Diclofenac sodium) suppositories are better than paracetamol infusion in controlling pain after gynecological surgeries and this difference is significantly better at 12 and 24 hours. Key words: Gynaecological surgery, Pain, Paracetamol, Voltral suppository How to cite: Khan Z., Khaleeq S., Rehman Ur A., Maan A., Farooq U. Nadeem A. Comparison Between Paracetamol Vs Voltral Suppositories for Post-Operative Pain in Gynaecological Procedures. Esculapio 2021;17(02):191-194.

2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Arley Sadra Telussa ◽  
Lukman Hakim ◽  
Doddy M Soebadi

Objective: To observe the effects of ropivacain peritubal infiltration in reducing postoperative pain and analgesic requirements postoperatively in patients underwent percutaneous nephrolithotomy (PNL). Material & method: Double blind randomized controlled trial on 32 patients with renal stone who underwent PNL at Soetomo General Hospital Surabaya from February until August 2017, divided into 2 groups. Experimental group (A) who received peritubal infiltration of ropivacain pre-operative, and control (placebo) group (B) Evaluation using Wong Baker pain score 2 hour post operation, time from operation until first rescue analgesia, and total analgesia given in first 24 hours. Result: Mean age was 51.81 ± 9.13 and 49.31 ± 10.53 years in group A and B respectively. Mean operation time 49.31 ± 10.53 and 89.69 ± 17.74 hours in group A and B respectively. There was no significant difference in stone complexity, nephrostomy placement and stenting between two groups. There was no significant difference of Wong Baker pain score 2 hours post operation between group A and B (p 0.72). There was no significant difference in total analgesia in the first 24 hours between group A and B (p 0.48). The time of first rescue analgesia demand was significantly longer in the experimental group (p 0.00). Conclusion: Peritubal infiltration of ropivacain in percutaneous nephrolitholapaxy is safe and effective to prolong the need of first rescue analgesia in post operative pain management which result in patients convenience.


2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.


Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.


2019 ◽  
Vol 27 (3) ◽  
pp. 179-185
Author(s):  
Mridul Janweja ◽  
Sayan Hazra ◽  
Arindam Das ◽  
Arya Brata Dubey

Introduction Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty. Materials and Methods Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared. Results Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group. Conclusion The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.


2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.


2020 ◽  
Vol 3 (01) ◽  
pp. 10-15
Author(s):  
Neeraj Suri ◽  
Satya Sandilya ◽  
Ruta Sayani ◽  
Amit Anand

Abstract Introduction The aim of our study is to compare the surgical complications of the transcanal and posterior tympanotomy approach and to evaluate the advantages and disadvantages of both techniques. Materials and Methods It is a prospective study involving 252 pediatric cochlear implant patients operated in the Department of ENT, GMERS Medical College and General Hospital, Gandhinagar, Gujarat, India. Out of these, 126 patients were operated by transcanal approach (group A) and 126 patients were operated by posterior tympanotomy approach (group B). Results No significant difference in the mean duration of surgery (p > 0.064) was observed in both the groups. Major complications occurred in 60.2% of group A and 3.1% of group B and minor complications occurred in 65% of group A and 3.1% in group B, which is highly significant (p < 0.0134). The categories of auditory perception, speech intelligibility rating scales, meaningful auditory integration scale, and meaningful use of speech scale were assessed in both groups. Conclusion Complication rate in the transcanal approach is higher as compared with posterior tympanotomy approach. A complete alignment and introduction of electrode array into the basal turn of cochlea is more favorable in the posterior tympanotomy approach. Transcanal technique even as an alternative may not be useful. Outcomes may be affected depending upon the technique chosen.


2019 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Ben Limbu ◽  
Hannah S Lyons ◽  
Mohan Krishna Shrestha ◽  
Geoffrey C Tabin ◽  
Rohit Saiju

Introduction: The first line treatment for nasolacrimal duct obstruction (NLDO) is external dacrocystorhinostomy (DCR). Following DCR, patients are required to return to Tilganga Institute of Ophthalmology (TIO) six weeks postoperatively for the removal of a silicone stent. As the majority of patients travel large distances at significant cost to reach TIO, most often patients remain within Kathmandu during this six weeks interval. This places a large financial burden on patients. Methods: A randomized controlled trial was designed to compare patient outcomes after early (two weeks postoperatively) versus standard (six weeks postoperatively) removal of silicone stents. 50 selected patients were randomized into two equal groups. Results: At the time of publication, 31 patients (14 in group A and 17 in group B) had completed three months follow up. A success rate of 92.9% was noted in Group A and a success rate of 94.1% observed in group B. No significant difference was found between the two groups for success rate and rate of complications. Conclusion: Early tube removal post DCR appears to cause no significant difference in outcome or complication rates compared to standard tube removal.


2020 ◽  
Vol 7 (12) ◽  
pp. 3986
Author(s):  
Arijit Roy ◽  
Pramatha Nath Datta ◽  
Kushankur Guha

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.


2018 ◽  
Vol 5 (3) ◽  
pp. 1041 ◽  
Author(s):  
Chandrashekar Reddy J. Madinur ◽  
Prashant Tubachi ◽  
Prashant Tubachi ◽  
A. S. Godhi ◽  
A. S. Godhi

Background: The primary function of the skin is to serve as a protective barrier against the environment. The process of wound healing constitutes an array of interrelated and concomitant events. Understanding these processes and various factors affecting these processes continue to expand. The present study was undertaken to compare and evaluate the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds.Methods: The present one year randomized controlled trial was conducted on all the patients undergoing appendicectomies for uncomplicated appendicitis and uncomplicated inguinal hernia repairs in the Department of Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of one year. Based on the thumb rule a total of 60 patients divided into two groups of 30 each were studied. Based on the computer-generated randomization patients were allocated to two groups that is group A (Inj. Piroxicam) and Group B (Inj. Diclofenac).Results: In the present study, males outnumbered females with male to female ratio between of 1.72 to 2:1. The mean age in group A was30.9±7.86 years and in group B it was 30.3±7.97 years. Both the groups that is Group A and B were graded under grade I (Good wound healing) from the POD 3 onwards. Overall the individual score and total scores had no influence of the final grading (outcome) of the wound.Conclusions: Overall, better results were seen on wound healing in patients who received Inj piroxicam with significantly less post-operative redness and edema. However, this did not have significant difference in the final outcome of the grading of the wound. 


JMS SKIMS ◽  
2011 ◽  
Vol 14 (2) ◽  
pp. 52-55
Author(s):  
Abdul Qayoom Lone ◽  
Nazia Nazir ◽  
Shehnaz Gilani ◽  
Mohammad Ommid ◽  
Showkat H Nengroo ◽  
...  

BACKGROUND: Recent clinical studies have demonstrated that children experience a similar severity of post operative pain as adults and that even preterm infants demonstrate alterations in heart rate, blood pressure and oxygen saturation in response to pain. OBJECTIVE: To study the advantage of tramadol wound infiltration over bupivacaine on post operative pain relief in children following inguinal herniotomy and orchiodopexy METHODS: In this prospective single blinded randomized controlled study, 705 children aged between 1–7 years undergoing elective repair of unilateral inguinal hernia and orchiodopexy were randomly divided into 3 groups of 25 each. Group A (Tramadol) à wound infiltration with 2mg/Kg Tramadol in 0.2ml/Kg saline, Group B (Bupivacaine) à wound infiltration with 0.2ml/Kg of 0.25% of Bupivacaine and Group C (Tramadol i/m) à 2mg/Kg tramadol intra muscularly 20 minutes before the end of surgery. Children were assessed post-anesthesia for pain score and discharged from Post Anesthesia Care Unit when they achieved a score of 10. RESULTS: Group A had lower pain scores than group B and C for the first 24 hours in the postoperative period. The other two parameters pulse rate and respiratory rate were also lower in group A. Moreover use of rescue analgesia was significantly lower in group A. CONCLUSION: Wound infiltration with tramadol is a good choice for post operative analgesia in children undergoing inguinal herniotomy and orchidopexy. JMS 2011;14(2):52-55


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