scholarly journals Intravenous Dexamethasone as an Adjuvant to Caudal Analgesia for Post Herniotomy Pain

2021 ◽  
Vol 15 (10) ◽  
pp. 3491-3493
Author(s):  
Muhammad Sharif ◽  
Muhammad Arif Baloch ◽  
Nazeer Ahmed ◽  
Zafar Ullah ◽  
Yasir Reda Toble
Keyword(s):  
Pain Relief ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Caudal Block ◽  
Rescue Analgesia ◽  
Adequate Pain Relief ◽  
Post Operative Pain ◽  
Caudal Analgesia

Objective: To compare the outcomes of caudal block with or without intravenous dexamethasone in controlling post-herniotomy pain in pediatric population Patients and Methods: A total of 90 patients who underwent inguinal herniotomy were included in this prospective comparative study. The study was conducted in a tertiary care setup in Qatar from Jan-2020 to May-2021. Patients were randomly allocated to two groups. Group A (dexamethasone) patients received dexamethasone intravenous 0.25 mg/kg in 5 ml of distilled water, 10 minutes before surgery. Group B (control) received 5 ml of normal saline, 10 minutes before surgery. The patients were followed for up to 240 minutes after surgery to determine adequate pain relief. Results: Mean age of the children included in this study was 7.11±1.95 years. There were 46 (51.1%) female children and 44 (48.9%) male children. Adequate post-operative pain relief was achieved in 30 (33.33%) patients, while rescue analgesia was needed in remaining 60 (66.67%) patients. Adequate pain relief was achieved in 24 (53.3%) children in dexamethasone group and in only 06 (13.3%) children in control group (p-value 0.001). Conclusion: In children undergoing herniotomy, Intravenous 0.25 mg/Kg of dexamethasone when used as an adjunct to bupivacaine for caudal block significantly reduces post-operative pain. Keywords: Caudal Block, intravenous dexamethasone, Post-operative pain Relief.

Postoperative Pain Relief: The Comparison of Bupivacaine before Incision and Near Closure of Wound

2021 ◽  
Vol 15 (10) ◽  
pp. 2622-2624
Author(s):  
Haq dad Durrani ◽  
Rafia Kousar ◽  
Ejaz Iqbal ◽  
Muhammad Abdul Aziz ◽  
Syed Aushtar Abbas Naqvi ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Subcutaneous Tissue ◽  
Difficult Problem ◽  
P Value ◽  
Trial Methodology ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Significant Difference

Background: Pain is the most common and most difficult problem faced by patients after operation. Due to inadequate management 30-70% patients suffer from post-operative pain. Acute pain resulting in chronic pain reduces quality of life and creates economic burden. Aim: To compare post-operative pain relief between infiltration of 0.25% bupivacaine into skin and subcutaneous tissue in the line of incision before incision and along edges of wound near completion of procedure. Study design: Randomized control trial Methodology: Sixty four patients were randomly divided into two groups i.e. (0.25% Bupivacaine 6 to 30ml) at the site of incision into skin and subcutaneous tissue Preincision (Group P) and (0.25% Bupivacaine 6 to 30ml) along the edges of wound at near closure of procedure (Group C). Intensity of pain was assessed on visual analogue scale in the recovery room, 3, 6 and 24 hours postoperatively.The time of first dose of rescue analgesia within 24 hours was also noted in both groups. Results: There was no statistically significant difference between two groups regarding age (p-value = 0.324), gender i.e. males (p=0.545) females (p=0.763) and duration of operation (P=Value=0.208). The mean time of rescue analgesia in Group P and Group C in minutes was 318.12±149.47 and 374.84±125.67 respectively (p value =1.5) reflecting no statistically significant difference. Conclusion: Postoperative analgesia and analgesic requirement do not differ significantly whether bupivacaine is infiltrated before incision or just before closure of wound. Keywords: Postoperative pain, bupivacaine, rescue analgesia, Preincision

scholarly journals Multisite ropivacaine for pain relief after laparoscopic cholecystectomy: a placebo controlled study at a tertiary care teaching hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 115
Author(s):  
Debasish Samal ◽  
Rashmiranjan Sahoo ◽  
Kalpita Patra
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Early Discharge ◽  
Controlled Study ◽  
Rescue Analgesia ◽  
Adequate Pain Relief ◽  
Intraperitoneal Instillation ◽  
Incisional Pain

Background: Laparoscopic cholecystectomy has emerged as the gold standard for gallstone diseases. The preference of laparoscopic cholecystectomy (LC) over open cholecystectomy (OC) is because of decreased pain and early discharge. Still pain remains as a major cause of concern. In this current study, we have evaluated the effect of Intraperitoneal instillation of Ropivacaine along with subcutaneous injection around the trocar sites in patients undergoing LC.Methods: In this prospective study two groups of patients were selected 50 patients in each group. Control groups were given 100ml of 0.9% NS and other group received 2mg/kg intraperitoneal ropivacaine 0.25% diluted in 100ml of NS. All the outcome results were documented and analyzed for conclusion.Results: When we compared the pattern of pain in both the groups over the period of 24 hours postoperative, it was revealed that in the group C shoulder pain was seen in 30% of cases, followed by incisional pain in 76%. Right hypochondriac pain was 84% and diffuse abdominal was 82%. In group R they were being 10%, 20%, 32% and 70% respectively. The postoperative rescue analgesia for group C was demanded after around 1 to 2 hours of reaching the ward whereas in the group R it was around 4 hours. Discharge after adequate pain relief was seen early in group R (24 hours) than in the group C (36-48hours).Conclusions: The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.

scholarly journals Comparative Study of Infiltration of Lidocaine with Adrenaline versus Sterile Water in Type 1 Tympanoplasty Performed under General Anaesthesia

2018 ◽  
Vol 26 (3) ◽  
pp. 213-218
Author(s):  
Santosh Uttarkar Pandurangarao ◽  
Sridurga Janarthanan
Keyword(s):  
Pain Relief ◽  
Comparative Study ◽  
General Anaesthesia ◽  
Tertiary Care ◽  
P Value ◽  
Sterile Water ◽  
Tertiary Care Centre ◽  
Type 1 Tympanoplasty ◽  
Post Operative Pain

Introduction It is a common practice to infiltrate 2% lignocaine with 1:2,00,000 adrenaline for Type 1 Tympanoplasty, even when the surgery is done under general anaesthesia. The purpose of this study is to evaluate the necessity of infiltration of lidocaine with adrenaline (2% lidocaine with 1:2,00,000 adrenaline) in Type 1 Tympanoplasty surgeries performed under general anaesthesia in terms of per-operative bleeding and post-operative pain relief.   Materials and Methods A double blinded, prospective randomized comparative study was conducted in a tertiary care centre. A total of 50 patients planned for Type 1 Tympanoplasty under general anaesthesia, for chronic otitis media, inactive, mucosal disease were selected and divided into two groups randomly. Group A (25 patients) received local infiltration of 2% Lidocaine with 1:2,00,000 adrenaline and Group B (25 patients) patients received infiltration of sterile water. The per -operative bleeding and post-operative pain relief were assessedat 2nd, 4th and 6th post-operative hour in both the groups and the results were analysed.   Results P value for per operative bleeding was <0.77 (non-significant). And the P value for post-operative pain relief at 2nd hour was <0.002 (significant). But the P value for 4th (<0.133) and 6th (<0.358) post-operative hours were not significant.   Conclusion Infiltration of 2% lidocaine with 1:2,00,000 adrenaline, doesn’t have any significant impact in per-operative bleeding and post-operative pain relief at 4th and 6th hour. But there is a significant pain relief, for 2 hours after surgery, when 2% lidocaine with 1:2,00,000 adrenaline is used for infiltration.

scholarly journals Comparison of intra-articular injection of local anaesthetic Ropivacaine versus Ropivacaine+Ketorolac and Ropivacaine+Tramadol for post-operative pain relief in knee and hip arthroplasty surgeries under spinal anaesthesia

2021 ◽  
Vol 8 (2) ◽  
pp. 199-204
Author(s):  
Anita Surana ◽  
Vipin Baxi
Keyword(s):  
Pain Relief ◽  
Spinal Anaesthesia ◽  
Hip Arthroplasty ◽  
Local Anaesthetic ◽  
P Value ◽  
Double Blind Study ◽  
Rescue Analgesia ◽  
Patient Satisfaction Score ◽  
Post Operative Pain ◽  
Knee And Hip Arthroplasty

Local anaesthetic infiltration in knee and hip arthroplasty is employed as a part of multi-model analgesia to reduce opiate consumption and help in early ambulation of elderly people It reduces post-operative pain effectively and thus reduces complications like Deep vein thrombosis, pulmonary embolism, pneumonia and even myocardial infection. Addition of ketorolac or Tramadol further prolongs the duration of analgesia. To compare the local anaesthetic infiltration of Ropivacaine alone and Ropivacaine with Ketorolac and Ropivacaine with tramadol for postoperative pain relief in knee and hip arthroplasty. Randomize double-blind study was conducted on 60 patients undergoing knee or hip arthroplasty under spinal anaesthesia. Group A patients received wound infiltration with Inj. Ropivacaine0.75% 50ml (5-7 mg/kg), Group B patients received Inj. Ropivacaine 0.75% 50 ml+1ml Inj. Ketorolac(30 mg) and Group C patients received Inj Ropivacaine 0.75% 50 ml+ Inj Tramadol 2ml (100mg), all diluted with NS to make 100 ml infiltration. Post-operative pain scores, time of first rescue analgesia (FRA), hemodynamic parameters and total rescue analgesic consumed in 24 hrs. as Inj Diclofenac and Tramadol was assessed and any untoward incidences like nausea, vomiting, knee swelling & Hypotension etc. were noted. The VA Score was significantly lower in Grp C as compared to Grp B and A in first 4-6 hrs. as tramadol and ketorolac significantly prolongs the duration of analgesia. VA score in Grp Cis 3.8+_0.52, as compared to 4.02 ± 1.58 in Grp B and 5.7 ± 1.014 in Grp A. which was statistically significant (P value 0.0141). The time of first rescue analgesia (FRA) was also prolonged by 2.2 hrs. in Grp C as compared to Grp B and C which is statistically significant. (P value 0.003). The total rescue analgesia in 24 hrs. given as Inj Diclofenac and Inj Tramadol was significantly lower in Grp C as compared to Grp B and A. No of pts requiring rescue analgesia was also less 45% in Grp C as compared to 50% and 95% in Grp B and A respectively. 25% pts in Grp C has excellent pain relief as compared to 20% in Grp B and 10% in Grp A. No untoward effect like nausea vomiting is noted in any patient, only 3 pts in Grp A and 2 pts in Grp B required bl transfusion. Local infiltration of Ropivacaine provides good analgesia. Addition of tramadol or Ketorolac prolongs the analgesic effect of Ropivacaine and lowers the VAS significantly and improves patient satisfaction score. It also decreases post-operative 24hrs NSAID or opioid consumption.

Comparison of Analgesic Efficacy of Nalbuphine Versus Tramadol as Adjuvant to Local Anaesthetic in Caudal Block in Children

2021 ◽  
Vol 15 (11) ◽  
pp. 3458-3460
Author(s):  
Muhammad Sharif ◽  
Muhammad Arif Baloch ◽  
Nazeer Ahmed ◽  
Zafar ullah ◽  
Yasir Reda Toble
Keyword(s):  
Group Versus ◽  
Analgesic Efficacy ◽  
P Value ◽  
Caudal Block ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
Mean Time

Objective: To compare the mean time of first analgesia with nalbuphine versus tramadol as adjuvant to bupivacaine for caudal block in children. Patients and Methods: In this randomized clinical trial, a total number of 60 children who were planned for caudal block after infra-abdominal surgeries having age 3-12 years were included. A caudal block was performed under general anaesthesia immediately after surgery for postoperative analgesia. Tramadol 2mg/kg body weight was given caudally to individuals in group A. Group B patients had 0.125 percent bupivacaine with 0.1mg/kg nalbuphine caudally. Time of requirement of first analgesia was noted in all patients. Paracetamol 10 mg/kg was given as rescue analgesic in all patients. Results: Mean age of patients was 8.30±3.03 years. Mean weight of patients was 23.33±6.92 Kg. There were 26 (43.33%) female patients and 34 (56.67%) male patients. There were 50 (83.33%) children who were having ASA status I, and remaining 10 (16.67%) children were having ASA status II. Mean pain score was 3.53±1.43 in tramadol group and 1.86±1.25 in Nalbuphine group (p-value <0.001. Mean time of first rescue analgesia was significantly prolonged in Nalbuphine group, mean time was 6.13±1.07 hours in Nalbuphine group versus 4.03±1.03 hours in tramadol group (p-value <0.001). Conclusion: Single dose of nalbuphine as an adjunct to bupivacaine is superior as compared to tramadol in reducing the post-operative pain, it also significantly prolongs the duration of analgesia in children. Keywords: Caudal Block, Nalbuphine, Tramadol, Post-operative pain, Time of first rescue analgesia.

scholarly journals Effect of acupuncture TENS versus conventional TENS on post cesarean section incision pain

2018 ◽  
Vol 7 (9) ◽  
pp. 3738
Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Control Group ◽  
P Value ◽  
Random Allocation ◽  
Lower Segment Caesarean Section ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.

scholarly journals Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy

2018 ◽  
Vol 6 (2) ◽  
pp. 6
Author(s):  
Kalpana Kharbuja ◽  
Mahesh Sharma ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
P Value ◽  
Anesthesia Induction ◽  
Chi Square ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Intravenous Paracetamol

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy. Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant. Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.   Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.

scholarly journals Evaluation of postoperative pain in closure versus non-closure of parietal peritoneum at caesarean section

2017 ◽  
Vol 6 (5) ◽  
pp. 1969
Author(s):  
Avantika Sharma ◽  
Nupur Hooja ◽  
Apoorv Shastri ◽  
Brijesh Dadhich ◽  
Richa Manish
Keyword(s):  
Postoperative Pain ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Parietal Peritoneum ◽  
P Value ◽  
Care Hospital ◽  
Post Operative Pain ◽  
Background Pain ◽  
One Year ◽  
Closure Group

Background: Pain is one of the major discomfort which drives post caesarean mothers to seek help. Thus, it is important to know if any change in surgical technique could have effect on the post-operative pain which affects all the woman’s activities. Hence, the study was undertaken to study the effect of closure and non-closure of parietal peritoneum on postoperative pain.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Detailed history, investigations, operative details, postoperative outcome in terms of pain were recorded and analysed.Results: Women in the closure group had more postoperative pain. P value was highly significant at 8h (P=0.0001), 16h (P=0.0001), 24h (P=0.00001) and 32h (P=0.000001), 40 hour (P=0.00001) and 48h (P=0.0001).Conclusions: Peritoneal should not be closed routinely in caesarean sections as it is shown to cause less postoperative pain.

scholarly journals Epidural analgesia during labour: its influences on pain relief, progress of labour, mode of delivery, maternal and foetal

2020 ◽  
Vol 9 (2) ◽  
pp. 555
Author(s):  
M. Suneetha ◽  
A. Saritha
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Control Group ◽  
Sitting Position ◽  
Tertiary Care Centre ◽  
Group 2

Background: Today, the availability of regional anaesthesia for labour is considered a reflection of standard obstetric care. This study is to be conducted in a tertiary care centre with all facilities available for proposed end of proving that epidural analgesia is a safe and effective method for both parturient and the foetus in abolishing pain during labour.Methods: A total of 60 parturients were studied. they were randomly divided into two groups Group 1 includes 30 parturients. In this group parturient received epidural analgesia. The loading dose consisted of 10 ml of Bupivacaine 0.1% and Fentanyl 0.0002% (20 mcg). The top up doses were 10 ml of 0.1% Bupivacaine and Fentanyl 0.0002%, administered whenever the parturient complained of pain. When parturients enters into second stage a further 12-15 ml was injected with parturient in sitting position or semi-sitting position. Group 2 - (control group) Includes 30 parturients. In this group parturient was monitored without any analgesia.Results: This prospective study was done to assess the effect of epidural analgesia on the progress of labour and its outcome, to evaluate its efficacy as an analgesic technique and to study the maternal and fetal outcome. The total number of 60 parturients were selected and randomly categorized into two groups. CASE-Those who received epidural analgesia, CONTROL-Those who did not receive any analgesia.Conclusions: Epidural analgesia provides a versatile method of administering effective and satisfactory pain relief to parturient women. The technique should not be considered as a single entity, because the type and the dose of epidural medication can be altered as needed.

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