Role of Pre-operative Intravenous Methylprednisolone for Post-operative Pain Control after IFF Surgery

2021 ◽  
Vol 15 (12) ◽  
pp. 3188-3190
Author(s):  
Umair Saleem ◽  
Kamran Afzal ◽  
Saqib Shoaib ◽  
Fareed Azam Khan
Keyword(s):  
Pain Score ◽  
Visual Analogue Scale Pain ◽  
Control Group ◽  
Intertrochanteric Fractures ◽  
Intravenous Methylprednisolone ◽  
Femur Fractures ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Intertrochanteric region are common in older ages. 33% females and 15% males in their 90s suffer from hip fracture, most commonly intertrochanteric fractures (50%). The pain associated with the surgery of the intertrochanteric fractures is quite troublesome and reduces patient mobilization thus increasing morbidity. Aim: To compare preoperative intravenous methylprednisolone vs control in terms of mean VAS score in patients presenting with intertrochanteric femur fractures. Study design: Randomized control trial Place and duration of study: Orthopaedic Department & General Surgery Department POF Hospital Wah Cantt and Izzat Ali Shah Hospital Wah Cantt from 1st Jan 2020 till 31st Dec 2020 Methodology: Sixty patients were enrolled and divided in two groups. Thirty patients in methylprednisolone group and 30 patients in control Group were enrolled. Age 40-75 years old people of both genders with intertrochanteric femur fractures were included. Post-operative pain was recorded at resting position and 45° hip flexion position 24 hours post-surgery through VAS. Results: In group A, 18 patients were males and 12 were female. In group B 19 patients were male and 11 were female. Mean age in group A was 56.37±4.56 years and in group B, 55.89±4.13 years. Mean VAS pain score in the control group was 5.03±1.542 while the mean VAS pain score in the treatment group was 3.70±15.79 (P=0.002). Conclusion: Methylprednisolone preoperatively reduces postoperative pain at 24 hours after surgery in patients undergoing intertrochanteric fracture fixation. Keywords: Methylprednisolone, Preoperative, Visual Analogue Scale, Pain, Postoperative’

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.

Abnormal Variations in the Expressions of LRP5, Runx2, Osterix and RANKL in Bone Tissues Associated With Postmenopausal Osteoporotic Fractures

2021 ◽  
Author(s):  
Bin Wang ◽  
Yanming Cao ◽  
Caiyuan Mai ◽  
Ram Ishwar Yadav ◽  
Jianliang Gao ◽  
...  
Keyword(s):  
Bone Repair ◽  
Osteoporotic Fractures ◽  
Expression Level ◽  
Control Group ◽  
Rankl Expression ◽  
Femur Fractures ◽  
Group A ◽  
Group B ◽  
And Control ◽  
Rank Signaling

Abstract Objective: To investigate the variations in the expressions of LRP5, Runx2, Osterix, and RANKL factors in bone tissues associated with postmenopausal osteoporotic fractures (PMOPF). Method: Postmenopausal patients with femur fractures were initially divided into control (31 cases) and PMOPF groups (83 cases). All control group patients were operated within 1 day after injury. The patients with PMOPF were operated based on the time after fracture in the respective groups (patients were divided into groups A, B, and C based on the time after fracture). Samples were collected from femurs at fracture sites during the operation. The expression level of each factor in bone tissues was detected using RT-qPCR, and the bone mass samples were decalcified and then histologically analyzed by immunohistochemistry. We subsequently analyzed significant differences in the expressions of factors (LRP5, Runx2, Osterix, and RANKL) between PMOPF and control groups. Results: (1) LRP5, β-catenin, Runx2, and Osterix were under-expressed in patients with PMOPF relative to the controls (P<0.05). In contrast, RANKL was over-expressed in the PMOPF group when compared to the control group (P<0.05); (2) the expressions of LRP5 and Runx2 were lowest in Group A patients (1–3 days after fracture). Osterix expression was lowest in Group C patients (8–14 days after fracture). Conversely, RANKL expression was highest in Group B patients (4–7 days after fracture). Conclusion: The inhibition or reduction in the expressions of osteogenic factors including LRP5, Runx2, and Osterix of the Wnt/β-catenin and BMP-2/Runx2/Osterix signaling pathways are associated with PMOPF incidence. Specifically, upregulation of RANKL in the RANKL/RANK signaling pathway is associated with the incidence of PMOPF. LRP5 and Runx2 expressions decreased considerably within 1-3 days after fracture; Osterix expression decreased considerably within 8-14 days after fracture; RANKL expression was highest within 4-7 days after fracture, which could be associated with bone repair in PMOPF. The expression level of the aforementioned factors affects the development and progression of PMOPF.

scholarly journals Ultrasonic cutting and coagulation device versus conventional diathermy dissection in thyroid surgery: prospective randomized trial

2018 ◽  
Vol 4 (2) ◽  
pp. 335
Author(s):  
Aditya Singhal ◽  
Dharma Kant Baskota ◽  
Kunjan Acharya
Keyword(s):  
Pain Score ◽  
Thyroid Surgery ◽  
Operative Time ◽  
Ultrasonic Device ◽  
Post Operative Pain ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Lottery System ◽  
Ultrasonic Cutting

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The objective of this study was to compare the operative time and postoperative outcomes in thyroid surgeries using the ultrasonic cutting and coagulation device with conventional diathermy dissection. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was a prospective, interventional, cohort study. The patients   were randomized in two groups by lottery system. The patients operated with ultrasonic device were labeled as Group A: UCCD and by conventional diathermy as Group B: CDD. The operative time, postoperative drain volume, pain score on VAS and complications were assessed and compared in between the two techniques of surgery.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Total of 18 males and 58 females underwent thyroid surgery with age ranging from 17 to 75 years. The operative time in UCCD group was less than CDD group (93.29 min vs. 106.59 min; p=0.06). The cumulative mean amount of drain was found to be less in UCCD group, this difference was statistically significant (77.86 ml vs. 138.05 ml; p=0.00018). The drain was removed earlier in UCCD group, this comparison was also statistically significant (2.49 days in UCCD group vs. 3.02 days in CDD group; p=0.000009). The mean pain score was found to be statistically significant on all the postoperative days in UCCD group. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The patients experienced less pain and complication while using UCCD as technique for surgery.  Hence, ultrasonic device using both cutting and coagulating mode at the same time is efficient in hemostasis and lesser post-operative pain, and found to be advantageous.</span></p>

scholarly journals A comparative study of adenoidectomy by microdebrider vs conventional method

2018 ◽  
Vol 4 (3) ◽  
pp. 808
Author(s):  
M. Muniraju ◽  
Mohammed Saifulla
Keyword(s):  
Pain Score ◽  
Recovery Time ◽  
Operative Time ◽  
Recovery Period ◽  
Collateral Damage ◽  
Adenoid Tissue ◽  
Post Operative Pain ◽  
Group A ◽  
The Mean ◽  
Group B

<p class="abstract"><strong>Background:</strong> Adenoidectomy is a commonly performed ENT surgery. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative for conventional curettage method.</p><p class="abstract"><strong>Methods:</strong> Sixty consecutive cases requiring adenoidectomy were randomized into two groups of thirty each. Group A underwent endoscopic assisted micro-debrider adenoidectomy and Group B underwent conventional adenoidectomy using the curettage method in study period from November 2015 to May 2017.  </p><p class="abstract"><strong>Results:</strong> The average time taken in Group A was 34.10 minutes and in Group B was 22.83 minutes (p&lt;0.001). The average blood loss in Group A was 29.57 ml as compared to 16.67 ml in Group B (p&lt;0.001). The resection was invariably complete in Group A whereas five (16.7%) cases had more than 50% residual adenoid tissue in Group B. Four cases in group B had collateral damage whereas in Group A, there were no added injuries. Post operative pain was studied only in cases undergoing adenoidectomy alone. Group A (n=8) demonstrated a pain score of 3.50 – 3.09 whereas Group B (n=11) demonstrated a pain score of 2.75-2.55. In group A, the mean recovery period was 2.80 days and 8.23 days in Group B (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic powered adenoidectomy was found to be a safe and effective tool for adenoidectomy. The study parameters where endoscopic powered adenoidectomy fared better were completeness of resection, accurate resection under vision, lesser collateral damage and faster recovery time. On the other hand, conventional adenoidectomy scored in matter of lesser operative time and intra-operative bleeding.</p>

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 ◽  
...  
Keyword(s):  
Pain Score ◽  
Controlled Trial ◽  
Gynaecological Surgery ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

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.

Reduction in Blood Loss with Tranexamic Acid use in Dynamic Hip Screw Surgery for Intertrochanteric Fractures

2021 ◽  
Vol 15 (7) ◽  
pp. 1657-1760
Author(s):  
Muhammad Akram ◽  
Ali Muqadas ◽  
Arif Mahmood ◽  
Faheem Mubashir Farooqi ◽  
Shumaila Jabbar
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Dynamic Hip Screw ◽  
Control Group ◽  
P Value ◽  
Intertrochanteric Fractures ◽  
Significant Difference ◽  
Group A ◽  
Hip Screw ◽  
Group B

Aim: To compare the mean decrease in hemoglobin levels in fixation of intertrochanteric fractures with or without use of Tranexamic acid. Methods: This study was conducted at Orthopedics Unit II, Mayo Hospital Lahore, Pakistan. Total 78 patients were included in the study. Duration of study was from 15-07-2017 till 15-01-2018.Study was approved by hospital ethical committee. A written informed consent was taken. Diagnosis was made clinically and with help of radiology. Patients were randomly divided into two groups. Patients in intervention Tranexamic acid (TXA) group received 15 mg/kg of Tranexamic acid at the time of induction of anesthesia and repeated after three hours, while those in the control group received placebo which is normal saline, intravenously. Results: There were 16(41%) males and 23(59%) females in group-A. There were 15(38.5%) males and 24(61.5%) females in group-B. Mean age in group A (control) with standard deviation was 44.2051±9.64141. Mean age in group B (TXA) was 45.9744±9.03061. p value 0.0046. Mean BMI in group A was 25.65±5.136. Mean BMI in group B was 24.307±2.153. p value 0.233. In group A 13(33.3%) patients had hypertension and 26(66.67%) did not have hypertension in group-A. In group B 16 (46.2%) patients had hypertension and 21 (53.8%) did not have hypertension in group-B. Mean fall in Hb in Group A was 9.47±1.054. Mean fall in Hb in group B was 9.547±0.9402. p value 0.001. Statistically significant difference was present in Group B (TXA) in term of mean fall in Hb ( p value 0.001). Conclusion: We in our study concluded that the patients in TXA group who were given tranexamic acid 1g intravenously before start of surgery had a lesser fall in mean Hb for the operative treatment of per trochanteric fractures with dynamic hip screw. Hence injecting tranexamic acid intravenously can effectively reduce the blood loss during DHS surgery for the intertrochanteric fractures. Keywords: Interochanteric fracture, tanexamic acid, blood loss

scholarly journals Comparison of gabapentin and oxycodone-acetaminophen used for pre-emptive analgesia in patients undergoing double-port thoracoscopic pulmonary surgery: a randomized, double-blind, controlled trial.

2019 ◽  
Author(s):  
Li Li ◽  
XiJuan Li ◽  
JinMei Shen ◽  
LiJun Zhou
Keyword(s):  
Chronic Pain ◽  
Adverse Events ◽  
Controlled Trial ◽  
Opioid Consumption ◽  
Control Group ◽  
Double Blind ◽  
Pulmonary Surgery ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Abstract Background This study was designed to determine whether gabapentin is not inferior to the oxycodone-acetaminophen group used as pre-emptive analgesia in reducing post-operative pain. The post-operative pain of patients undergoing thoracoscopic pulmonary surgery, a routine operation procedure, is also a clinical problem that urgently needs to be further explored. We hypothesized that gabapentin is not inferior to oxycodone-acetaminophen.Methods Ninety patients were randomly divided into group A,n=30; group B,n=30; and group C,n=30. Patients in group A received oral gabapentin (300 mg) 2 h before surgery, similarly patients in group B received oral oxycodone-acetaminophen (330mg);Group C did not take any oral drugs; all patients were given self-controlled intravenous analgesia after surgery. NRS scores post-operative, opioid consumption 48 hours post-operative, analgesic-related adverse events, post-operative chronic pain after 2 months, were recorded.Results The NRS scores and opioid consumption 48 hours post-operative of intervention groups were significantly lower than the control group, and did not increase analgesic-related adverse events. The incidence of chronic pain 2 months post-operative in groups A and B was significantly lower than group C.Conclusion Oral gabapentin and oxycodone-acetaminophen alleviated the pain post-operative, reduced opioid consumption post-operative,promoted the recovery.

scholarly journals Comparison of hemorrhoidectomy versus hemorrhoidectomy and internal sphincterotomy in terms of postoperative pain.

2020 ◽  
Vol 27 (04) ◽  
pp. 677-681
Author(s):  
Afiya Zulfikar ◽  
Usman Qureshi ◽  
Muhammad Salman Shafique ◽  
Jahangir Sarwar Khan
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Controlled Trial ◽  
Control Group ◽  
Chi Square ◽  
Internal Sphincterotomy ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
The Mean ◽  
Group B

Objectives: To compare open hemorrhoidectomy with internal sphincterotomy versus open hemorrhoidectomy alone in terms of frequency of the postoperative pain. Study Design: Randomized Controlled Trial. Setting: Surgical Unit - I, Holy family Hospital, Rawalpindi. Period: For one year  i.e. from January 2016 to December 2016. Material & Methods: 250 patients were divided in two equal groups by lottery method. The surgical procedure was performed using standard protocols after obtaining written informed consent. Anal dilatation was done  after open hemorrhoidectomy in patients of control group (Group A). In the study group (Group B), the patients were subjected to lateral internal sphincterotomy after completion of classical open hemorrhoidectomy. Postoperative pain score was recorded by using visual analog scale. Difference between both groups for pain was analyzed using chi-square test. Results: There were 68 males and 57 females in Group-A and 61 males and 64 females in Group-B. The mean age of patients in Group-A was 33.10±8.77years and in Group-B was 32.52±9.4years. The mean pain score of patients in Goup-A and Group-B was 2.82±2.51 and 1.59±1.58 respectively (P<0.05). In Group-A, 94 (75.2%) cases had no pain while in Group-B, 116 (92.8%) cases were pain free following the procedure. The difference between both groups was significant i.e. P < 0.05. Conclusion: Open hemorrhoidectomy with internal sphincterotomy is effective in reducing postoperative pain.

scholarly journals Use of diclofenac suppositories in pain management in acute fissure in ano in outpatient department care

2019 ◽  
Vol 7 (1) ◽  
pp. 90
Author(s):  
Juthikaa Abhijit Deherkar
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Anal Verge ◽  
Outpatient Department ◽  
Control Group ◽  
Fissure In Ano ◽  
Oral Tablet ◽  
Tertiary Centre ◽  
Group A ◽  
Group B

Background: Per anal diseases and the pain management in such cases have always been a problematic solution for surgeons. There are various pain management methods for per anal cases, however we wanted a cheaper yet effective way and patient friendly method for pain management where no expertise would be required, hence we opted to see results of diclofenac suppositories which were easily available, patient could insert it without anyone’s help or assistance and hence need not be hospitalized for any intravenous analgesics.Methods: A study was conducted over 2000 cases over a span of 6 years in a tertiary centre. A control group A of 1000 patients was made where, oral (tablet diclofenac) plus local analgesics (xylocaine gel) were opted for whereas the other group B of 1000 patients was treated with diclofenac suppository 100 mg twice a day with glycerin as lubricant at anal verge. The pain score was noted in both the groups. All acute fissure in ano cases, we included in this study.Results: The pain score of the group B cases was much lower than the group A cases, and also the duration of results acquired was much lesser than group A.Conclusions: Diclofenac suppository 100 mg twice a day proved to be an excellent pain management method for acute fissure in ano cases in outpatient department care.

scholarly journals A CLINICAL STUDY ON MANAGEMENT OF POST-OPERATIVE PAIN AND QUALITY OF LIFE OF OSTEOARTHRITIS PATIENTS AFTER TOTAL KNEE ARTHROPLASTY

2018 ◽  
Vol 11 (4) ◽  
pp. 93
Author(s):  
Tamilslevan T ◽  
Kalaivani H
Keyword(s):  
Quality Of Life ◽  
Pain Score ◽  
Post Operative Pain ◽  
Group A ◽  
Total Knee ◽  
Inflammatory Drugs ◽  
Group B ◽  
Pain Symptoms

 Objective: The objective of this study is to assess the effect of pregabalin in the management of post-operative pain and the quality of life (QOL) of osteoarthritis (OA) patients after total knee arthroplasty.Methods: This prospective observational study was conducted in the Department of Orthopedics. A total of 96 patients were divided into two groups. Group A consists of 50 patients with the treatment of nonsteroidal anti-inflammatory drugs (NSAIDs) and Group B consists of 46 patients with the treatment of pregabalin with NSAIDs. The study subjects were followed once in 60 days for 6 months, and they were asked to answer the visual analog scale (VAS) and knee injury and OA outcome score (KOOS) questionnaire. The effect of the treatment was assessed by comparing the baseline score with follow-up score.Results: Our study result showed that the pain score of Group B in VAS at 2nd follow-up was 2.56±0.34 and KOOS pain score was 92.73±3.45 (p<0.01). The QOL score was improved significantly to 81.56±5.29 (p<0.01) as compared to Group A.Conclusion: The study concluded that pregabalin with NSAIDs group patients showed a better improvement in pain, symptoms, and QOL within short duration as compared to NSAIDs alone used group.

Sign in / Sign up

Export Citation Format

Share Document