Efficacy of Bupivacaine Infiltration in Post Tonsillectomy Pain Relief

2021 ◽  
Vol 15 (12) ◽  
pp. 3144-3146
Author(s):  
Rafia Kousar ◽  
Haq Dad Durrani ◽  
Muhammad Abdul Aziz ◽  
Adnan Ejaz Qureshi ◽  
Kamran Chaudehry ◽  
...  

Background: Tonsillectomy is a common surgical procedure required to prevent recurrent infection, inflammation and related distress to the patients. Intervention in this highly vascularized area results in inflammatory responses and subsequent pain. Due to inadequate management 30-70% patients suffer from post-operative pain. Post tonsillectomy pain has its impact on analgesic consumption, hospital stay and return to normal activity. Methodology: This randomized control trial study design is a prospective randomized controlled including convenience sample of 32 patients of both genders, aged 4-30 years undergoing tonsillectomy.Tonsillectomy was performed by standard dissection method after giving general anesthesia to the patients. After completing the tonsillectomy on right side, surgeon infiltrated 6ml of 0.25 % bupivacaine in the tonsillar fossa on the right side. The surgeon did not infiltrate into the left side being observed as control. Postoperative pain score was recorded by asking patients on a VAS graded 1-10 scale (0= no pain and 10= maximum pain) after half an hour in recovery, 2 hours, 4 hours and 6 hours after the operation. Results: The mean age of the study patients was 14.08±7.32 years which included 20 (62.5%) females and 12(37.5%) males. The mean of duration of operation was 42.03±14.75 minutes. There was statistically significant difference between pain scores on VAS in infiltrated bupivacaine (right side) and control (left side) after ½, 2,4 and 6 hours respectively. Conclusion: Infiltration of 0.25% bupivacaine significantly reduces post tonsillectomy pain. Keywords: Tonsillectomy, Bupivacaine infiltration, Pain

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 526.1-526
Author(s):  
L. Nacef ◽  
H. Riahi ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  

Background:Hypertension, diabetes, and dyslipidemia are traditional risk factors of cardiac events. Carotid ultrasonography is an available way to detect subclinical atherosclerosis.Objectives:This study aimed to compare the intima-media thickness in RA patients based on their personal cardiovascular (CV) history of hypertension (hypertension), diabetes, and dyslipidemia.Methods:The present study is a prospective study conducted on Tunisian RA patients in the rheumatology department of Mohamed Kassab University Hospital (March and December 2020). The characteristics of the patients and those of the disease were collected.The high-resolution B-mode carotid US measured the IMT, according to American Society of Echocardiography guidelines. The carotid bulb below its bifurcation and the internal and external carotid arteries were evaluated bilaterally with grayscale, spectral, and color Doppler ultrasonography using proprietary software for carotid artery measurements. IMT was measured using the two inner layers of the common carotid artery, and an increased IMT was defined as ≥0.9 mm. A Framingham score was calculated to predict the cardiovascular risk at 10-year.Results:Forty-seven patients were collected, 78.7% of whom were women. The mean age was 52.5 ±11.06 [32-76]. The rheumatoid factor (RF) was positive in 57.8% of cases, and anti-citrullinated peptide antibodies (ACPA) were positive in 62.2% of cases. RA was erosive in 81.6% of cases. Hypertension (hypertension) was present in 14.9% of patients, diabetes in 12.8% of patients, and dyslipidemia in 12.8% of patients. Nine patients were active smokers. The mean IMT in the left common carotid (LCC) was 0.069 ±0.015, in the left internal carotid (LIC) was 0.069 ±0.015, in the left external carotid (LEC) was 0.060 ±0.023. The mean IMT was 0.068 ±0.01 in the right common carotid (RCC), 0.062 ±0.02 in the right internal carotid (RIC), and 0.060 ±0.016 in the right external carotid (REC). The IMT was significantly higher in the left common carotid (LCC) in patients with hypertension (p=0.025). There was no significant difference in the other ultrasound sites (LIC, LEC, RCC, RIC, and REC) according to the presence or absence of hypertension. The IMT was also significantly increased in patients with diabetes at LCC (p=0.017) and RIC (p=0.025). There was no significant difference in the IMT at different ultrasound sites between patients with and without dyslipidemia.Conclusion:Hypertension was significantly associated with the increase in IMT at the LCC level in RA patients. Diabetes had an impact on IMT in LCC and RIC. However, dyslipidemia did not affect the IMT at the different ultrasound sites.References:[1]S. Gunter and al. Arterial wave reflection and subclinical atherosclerosis in rheumatoid arthritis. Clinical and Experimental Rheumatology 2018; 36: Clinical E.xperimental.[2]Aslan and al. Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis. SCANDINAVIAN CARDIOVASCULAR JOURNAL, 2017.[3]Martin I. Wah-Suarez and al, Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case-control study. Int J Rheum Dis. 2018;1–7.[4]Gobbic C and al. Marcadores subclínicos de aterosclerosis y factores de riesgo cardiovascular en artritis temprana. Subclinical markers of atherosclerosis and cardiovascular risk factors in early arthritis marcadores subclínicos de aterosclerose e fatores de risco cardiovascular na artrite precoce.Disclosure of Interests:None declared


1994 ◽  
Vol 3 (5) ◽  
pp. 374-381 ◽  
Author(s):  
A Verderber ◽  
KJ Gallagher

BACKGROUND: Baseline data are needed to provide a foundation for future studies investigating the effects of various nursing interventions on the oxygen requirements of critically ill patients. OBJECTIVES: To establish reference values for the oxygen requirements of adults in response to three common patient events: a nurse-administered bed bath, passive range-of-motion exercises, and turning from side to side; and to determine whether the order in which the interventions were administered had an effect on oxygen consumption. METHODS: A convenience sample of 30 healthy men and women were randomly assigned to one of three treatment groups, for which the order in which interventions were to be administered had previously been designated. Data were analyzed using analysis of variance with repeated measures. RESULTS: There was a significant difference in the mean oxygen consumption among activities, as well as between men and women, with men having a significantly higher mean oxygen consumption than that of the women. For both men and women, the mean oxygen consumption during unassisted turning and back care was significantly higher than at baseline. The oxygen consumption for men averaged 4.25 mL/kg per minute, SD = .71 at baseline, 5.08 mL/kg per minute, SD = .98 for turning, and 4.72 mL/kg per minute, SD = .90 during back care. Women averaged 3.74 mL/kg per minute, SD = .49 at baseline, 4.48 mL/kg per minute, SD = .85 for turning, and 3.89 mL/kg per minute, SD = 1.15 during back care. Changes in oxygen consumption for other interventions were nonsignificant and negligible. Oxygen consumption returned to near baseline within 15 minutes of cessation of activity. The order in which interventions were administered did not have a significant effect on oxygen consumption. CONCLUSIONS: The anterior bath and passive range of motion exercises have minimal effect on oxygen consumption. Turning and back care significantly increase oxygen consumption from the baseline value. The order in which interventions are administered does not have any appreciable effect on oxygen consumption.


2019 ◽  
Vol 99 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Abdul-Latif Hamdan ◽  
Elie Khalifee ◽  
Georges Ziade ◽  
Sahar Semaan

The objective of this study is to investigate the dimensional and volumetric measurements in the thyroarytenoid (TA) muscle in men and women using magnetic resonance imaging (MRI). The hypothesis is that there is a gender-related difference in these measurements. A retrospective chart review of 76 patients who underwent MRI of the neck at the American University of Beirut Medical Center was conducted. The dimension and volume of the right and left TA muscle were measured on axial and coronal planes short tau inversion recovery images. Male and female groups were compared with respect to demographic data and MRI findings using parametric and nonparametric tests. The mean length of the thyro-arytenoid muscle in males was larger than that in females on the right (males 2.44 [0.29] cm vs females 1.70 [0.22] cm) and on the left (males 2.50 [0.28] cm vs females 1.72 [0.24] cm) reaching statistical significance ( P < .001). The mean width of the thyro-arytenoid muscle in males was larger than that in females on the right (males 0.68 [0.13] cm vs females 0.59 [0.11] cm) and on the left (males 0.68 [0.12] cm vs females 0.57 [0.12] cm) reaching statistical significance ( P < .001). The mean height of the thyro-arytenoid muscle in males was larger than that in females on the right (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) and on the left (males 1.05 [0.21] cm vs females 0.95 [0.12] cm) reaching statistical significance ( P < .01 on the right and P < .05 on the left). The volume of the thyroarytenoid muscle in males was larger than that in females on the right (males 0.86 [0.25] mL vs females 0.48 [0.15] mL) and on the left (males 0.89 [0.27] mL vs females 0.48 [0.17] mL) reaching statistical significance ( P < .001). The results of this investigation clearly indicate a significant difference in these measurements between men and women.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5177-5177
Author(s):  
Antonella Meloni ◽  
Daniele De Marchi ◽  
Vincenzo Positano ◽  
Gaetano Giuffrida ◽  
Sabrina Armari ◽  
...  

Abstract Abstract 5177 Background. Renal dysfunction has been reported in adult subjects with thalassemia major (TM) since 1975. One of the main cause is the iron overload consequent to regular transfusions. Multiecho T2* MRI is a well-established technique for cardiac and hepatic iron overload assessment, but there very few report concerning the kidneys. The aims of this study were to describe the T2* values of the kidneys in patients with TM, to investigate the correlation between renal and myocardial or hepatic siderosis and biventricular cardiac function. Methods. 119 TM patients (58 men, 30. 7 ± 8. 2 years) enrolled in the Myocardial Iron Overload (MIOT) networks underwent MRI. For the measurement of iron overload, multiecho T2* sequences were used. The left ventricle was segmented into a 16-segments standardized model and the T2* value on each segment was calculated as well as the global value. In the liver, the T2* value was assessed in a single region of interest (ROI) in a homogeneous area of the parenchyma. For each kidney, T2* values were calculated in three different ROIs and were averaged to obtain a representative value for the kidney. The mean T2* value over the kidneys was also calculated. Cine images were obtained to quantify biventricular morphological and functional parameters in a standard way. Results. T2* values in the right kidney were significant lower than in the left kidney (40. 3±11. 9 ms vs 44. 1±12. 7 ms, P<0. 0001). The mean T2* value over the kidneys was 42. 2±11. 9 ms and 40 patients (33. 6%) had a pathological value (T2*<36 ms, lower limit of normal evaluated on 20 healthy subjects). The mean T2* value did not show a significant difference amongst men ad women (43. 2±11. 7 ms versus 41. 3±12. 1 ms, P=0. 378). The mean T2* values increased with age in a significant manner (r=0. 321, P<0. 0001). There was a significant negative correlation between serum ferritin levels and mean renal T2* values (r=-0. 446, P<0. 0001). Significant positive correlations of the mean T2* values were demonstrated for liver (r=0. 511, P<0. 0001) and global heart (r=0. 262, P=0. 004) T2* values (Figure 1). No correlation was found between renal iron overload and bi-ventricular function parameters. Conclusions. Systemic T2* differences between left and right kidneys were found, with significant lower values in the right one. Mean T2* value increased with age. We confirmed that kidney iron deposition was not very common in TM, but it was correlated with iron deposition in liver and heart. Disclosures: No relevant conflicts of interest to declare.


2006 ◽  
Vol 18 (4) ◽  
pp. 477 ◽  
Author(s):  
C. H. McDonald ◽  
D. A. Taggart ◽  
W. G. Breed ◽  
G. V. Druery ◽  
G. A. Shimmin ◽  
...  

The effect of the exogenous administration of porcine follicle-stimulating hormone (pFSH) and pregnant mare serum gonadotrophin (PMSG) on ovarian follicular development and oocyte maturation in the southern hairy nosed wombat Lasiorhinus latifrons was investigated. Three experimental groups were administered pFSH at various doses and for different treatment lengths, followed by 25 mg porcine luteinising hormone (pLH) 12 h after the last dose of pFSH. Another group was given PMSG followed 72 h later by 25 mg pLH. Animals were killed 24 h after pLH. The left ovary was fixed for histology and the morphology of the antral follicles was determined, whereas follicular oocytes in the right ovary were aspirated, fixed, stained with 4′,6′-diamidino-2-phenylindole, and viewed for nuclear maturation. There was no significant difference in the mean number of ovarian follicles >1 mm, or in the size class of follicles assessed between control and experimental groups. However, a trend was observed suggesting a possible increase in follicles >3.0 mm in experimental groups compared with control animals. In all females administered exogenous porcine gonadotrophins, but not controls, some of the mural granulosa cells of large tertiary antral follicles had markedly enlarged nuclei (approximately 14 µm in diameter). All oocytes from the control group remained at the germinal vesicle stage, whereas approximately 40% of oocytes retrieved from the pFSH groups and 82.4% retrieved from the PMSG-primed animals had undergone germinal vesicle break down, with a small number reaching meiosis II. The present study shows that exogenous administration of either pFSH or PMSG to hairy nosed wombats can induce follicular growth and oocyte maturation. Such findings could be useful in the development of reproductive technology in this species.


2009 ◽  
Vol 79 (2) ◽  
pp. 265-270 ◽  
Author(s):  
Claudia A. Reicheneder ◽  
Peter Proff ◽  
Uwe Baumert ◽  
Tomas Gedrange

Abstract Objective: To test the null hypothesis that there are no differences between children and adults in maximum laterotrusion and maximum retrusion on the right and left sides. Materials and Methods: This population-based study included 81 randomly selected children between the ages of 6 and 10 years and 67 adults. Kinematic variables were measured with the ultrasonic JMA-System for registration. Results: The mean maximum laterotrusion of the children's group (10.6 ± 1.5 mm on the left, 11.0 ± 1.7 mm on the right) was significantly smaller than that of the adult group (11.7 ± 2.0 mm on the left, 12.2 ± 1.7 mm on the right). The maximum laterotrusion of the children's group corresponded to about 90% on the left and right sides of that of the adult group. The mean maximum retrusion of the children's group was significantly bigger than that of the adult group. There, the adult values corresponded to 66.7% on the left and 50% on the right side of the children's values. No significant difference in maximum laterotrusion and retrusion was noted on the right and left sides, and no significant differences according to gender specificities were observed in either group. Conclusions: The hypothesis is rejected. In development of the temporomandibular joint, maximum laterotrusion on the right and left sides increases significantly with age, and maximum retrusion decreases significantly with age.


2021 ◽  
Vol 87 (1) ◽  
pp. 175-179
Author(s):  
Thibault Dewilde ◽  
Sebastiaan Schelfaut ◽  
Sven Bamps ◽  
Matthias Papen ◽  
Pierre Moens

Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Level of evidence : IV – case series


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Qingchen Li ◽  
Yuan Zong ◽  
Huiming Wen ◽  
Jian Yu ◽  
Changbo Zhou ◽  
...  

Purpose. To study the variation of iris thicknesses in different regions and explore the possible correlations with age and gender. Methods. Healthy Chinese adults were recruited; the anterior segment of their eyes was imaged by swept-source optical coherence tomography (SS-OCT). The horizontal scan of the right eye was selected, and the thicknesses of both the nasal and temporal irises were measured at 199 evenly spaced points. Results. A total of 233 subjects with an average age of 36.79 ± 10.04 years (range 19 to 62) were included in the final analysis. The mean iris thicknesses of the temporal and nasal sides were 364.79 ± 47.58 μm and 372.44 ± 43.75 μm, respectively. The mean nasal iris thickness was positively correlated with age (β = 0.9 μm/year; P  = 0.002), but the temporal one was not (β = 0.077 μm/year; P  = 0.806). At 139 points of the nasal iris and 146 points of the temporal iris, the iris thickness was significantly correlated with age ( P  < 0.05). The thicknesses of the peripheral and pupillary parts were positively correlated with age, while the middle part was negatively correlated with age. No significant difference was observed in the mean iris thickness between genders (temporal: t = 1.597, P  = 0.112; nasal: t = 1.870, P  = 0.063), but females had a thicker iris than males at 50 points in the temporal side and 49 points in the nasal side ( P  < 0.05); no point in males was observed to have thicker iris compared to females. Conclusion. Using SS-OCT and the novel method, thicknesses of the iris at different regions were measured. The thicknesses of the peripheral and pupillary irises increase with age, while the thicknesses of the middle part decrease.


1970 ◽  
Vol 18 (2) ◽  
pp. 84-88
Author(s):  
Akhtari Afroze ◽  
M Durrul Huda

This study was aimed to find out the variations of the femoral head diameters in relation to sex in Bangladeshi people. The study was based on 123 paired human femurs (radiological view) of which 52 were male and 71were female. It was observed that the mean vertical and transverse diameters of the head of the male femur were significantly greater than that of female (P<0.001).No statistical significant difference was present between the measurement of the right and left side of the same sixth identification points that were derived from the vertical and transverse diameters of the head of the femur were higher in males than in females. The results showed that diameters of the femoral head as well as the identification points that are derived from them are of use in sex identification. The present study is of value to the forensic experts, orthopaedicians and prosthetists as it gives the idea about the dimensions of the femoral head in the present area.   doi: 10.3329/taj.v18i2.3172 TAJ 2005; 18(2): 84-88


2017 ◽  
Vol 55 (2) ◽  
pp. 168-172 ◽  
Author(s):  
Omer Demirtas ◽  
Fahrettin Kalabalik ◽  
Asim Dane ◽  
Ali Murat Aktan ◽  
Ertugrul Ciftci ◽  
...  

Objective: The purposes of this study were to evaluate and compare the maxillary sinus volume (MSV) of patients with a unilateral cleft lip and palate (UCLP) between the cleft side and noncleft side and between adolescent patients with UCLP and a control (noncleft) group using cone beam computed tomography (CBCT). Methods: CBCT images of 44 UCLP patients (29 males and 15 females, with a mean [SD] age of 13.5 [5.0] years) and 44 (22 males and 22 females, with a mean [SD] age 14.9 [4.2] years) age- and sex-matched controls were evaluated in this study. Each maxillary sinus was assessed 3-dimensionally, segmented, and its volume was calculated. Results: There were no statistically significant differences between the age and gender distributions of the groups. There was a statistically significant difference in the MSVs of the cleft (10996.78±3522.89 mm3) versus the noncleft side (10382.3±3416.2 mm3; P < .05)] but no significant difference between the MSVs of the right and left sides ( P > .05). In the intergroup comparison, the mean MSVs of the UCLP patients (10701.52±3369.33 mm3) were significantly smaller than those of the control group (16054.08 ± 5293.96 mm3; P < .001). Conclusions: The MSVs of the UCLP patients showed a statistically significant decrease compared to those of the controls ( P < .001). There was also a significant difference in the MSVs of the cleft and noncleft sides of the UCLP patients ( P < .05).


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