Comparison of Postoperative Mean Morphine Consumption in patients given Preoperative Gabapentin and Placebo undergoing Major Laparotomies for Lower Abdomen and Pelvis

2021 ◽  
Vol 15 (6) ◽  
pp. 1223-1224
Author(s):  
T. Iqbal ◽  
R. Farooqi ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat

Aim: Comparison of postoperative mean morphine consumption in patients given preoperative gabapentin and placebo undergoing major laparotomies for lower abdomen and pelvis. Study design: Randomized controlled trial Setting: Anaesthesia department, Hameed Latif hospital, Lahore Duration: Six months i.e. 20-04-2008 to 21-10-2008 Methods: 150 patients having major laparotomies were divided in group I i.e. 75 subjects with multivitamins as control and group II i.e.75 patients with Gabapentin. The two groups were compared for the consumption dose of opioid analgesia, postoperatively. Student’s t test was applied and p<0.05 was taken as significant. Results: The mean dose of tramadol consumed by the patients in group I was 43.6±18.9 mg and in group II was 14.7±5.7 mg. Conclusions: Preoperative use of Gabapentin before laparotomies reduces the morphine usage postoperatively. Keywords: Gabapentin; postoperative analgesia; morphine consumption:

1992 ◽  
Vol 68 (04) ◽  
pp. 404-406 ◽  
Author(s):  
Kagehiro Amano ◽  
Masaki Tateyama ◽  
Hiroshi Inaba ◽  
Katsuyuki Fukutake ◽  
Michio Fujimaki

SummaryPlasma thrombomodulin (TM) has attracted considerable attention as a marker of endothelial cell membrane injury. We examined fluctuations in plasma TM levels in patients receiving therapy for the disseminated intravascular coagulation syndrome (DIC) using an enzyme immunoassay. Sixty healthy controls and 18 patients with DIC were studied.The mean ± SD of the TM values initially measured immediately after the onset of DIC was 42.00 ± 20.85 ng/ml, which was markedly increased as compared with the control value of 15.36 ±4.85 ng/ml (p <0.001).Fluctuations in the TM levels over time were studied after dividing the patients according to the presence or absence of improvement in the underlying disease and improvement or lack thereof in the coagulation findings. Group I showed improvement in both categories, Group II showed improvement only in the latter, and Group III showed no improvement in either category.In Group I, the mean ± SD of initial measured TM levels was 37.02 ±10.12 ng/ml and the mean of final values decreased to 58.9% of the initial value. This decrease was significant by paired Student’s t-test (p <0.01). The initial value in Group II was 45.86 ± 18.86 ng/ml and the final values increased to 117.0% of the initial values, this difference was not significant. The initial value in Group III was 44.48 ±21.53 ng/ml and the final values increased to 143.4% of the former. This increase was significant by paired Student’s t-test (p <0.05). The difference in % fluctuations between Group I and Group III was significant by Wilcoxon’s test (p <0.01).These results suggest that the measurement of plasma TM can be useful in the management of DIC.


2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.


Author(s):  
Neelamma Girish Patil ◽  
Priyanka Gupta ◽  
Megha D. Hittinhalli ◽  
Subhaschandra R. Mudanur ◽  
Manpreet Kaur J. Tehalia ◽  
...  

Background: Since the second trimester termination of pregnancy is on rise due to the detection of anomalies, this study aims to provide a safe regimen with respect to efficacy, side effects and acceptability for second trimester pregnancy termination.Methods: It is a randomized controlled trial, conducted on 48 cases at BLDE Medical college, Vijayapur, Karnataka. They were divided into two groups; all patients were given mifepristone 200mg orally followed by misoprostol 400mcg vaginally after 12 hours in group I and 24 hours in group II respectively. Subsequent doses were decided depending on the Bishops score. Results were analyzed in terms of induction-abortion interval and dosage of misoprostol.Results: The mean induction abortion interval was 563.9 minutes (9.3hrs) in group I and 714.6 minutes (11.9hrs) in group II; but was statistically not significant (p value 0.611) The total dose of misoprostol used was 783.3mcg in group I compared to 550mcg in group II, but was statistically not significant. The success rate was 100% in both the groups as none of them had incomplete abortion. There were no cases of uterine rupture, infection, need for check curettage and laparotomy.Conclusions: Our study proves that the interval between mifepristone and misoprostol can be safely reduced to 12 hours without affecting the efficacy. But in gestational age <16 weeks and primigravida 24 hours interval may be of benefit. Both the regimens were 100% successful.


2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.3-482
Author(s):  
A. Moshrif ◽  
M. Elwan ◽  
U. Daifallah

Background:Deep friction massage (DFM) has long been proven to be effective in the treatment of some tendinopathies.Objectives:to evaluate the efficacy of DFM in the treatment of plantar fasciitis (PF) in comparison with local steroid injection.Methods:In this randomized controlled trial, 60 patients with PF were selected from those attending the rheumatology and rehabilitation outpatient clinic and then randomized to receive either 40 mg triamcinolone local injection (group I: 30 patients; 41 heals) using the medial approach or to receive seven sessions of deep transverse friction massage (10 min each) every other day (group II: 30 patients; 36 heels). The outcome measures were the pain and function assessment by visual analog scale and foot function index, respectively, at 2 and 6 weeks of follow-up.Results:Demographic data showed a statistically insignificant difference in age, female to male ratio, and BMI in both groups. The mean age was 39.42 years in group I and 41.32 years in group II (P=0.86). The female to male ratio was 3: 1 in group I and 2.75: 1 in group II, and the mean BMI was 32.41 in group I and 33.31 in group II (P=0.51). At 2 and 6 weeks of follow-up, DFM led to less improvement in pain and function compared with local steroid injection (P=0.001 and 0.002, respectively, at both time points of follow-up).Conclusion:This study revealed that DFM is not effective as a single modality in treatment of PF. Further large-scale studies are needed to support this observation.Disclosure of Interests: :None declared


2012 ◽  
Vol 5 (1) ◽  
pp. 37-43
Author(s):  
ABMM Alam ◽  
M Moniruzzaman ◽  
MB Alam ◽  
N Islam ◽  
F Khatoon ◽  
...  

Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction.Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development.Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12227 Cardiovasc. j. 2012; 5(1): 37-43


2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  


2010 ◽  
Vol 12 (5) ◽  
pp. 525-532 ◽  
Author(s):  
Kyeong Hwan Kim ◽  
Sang-Ho Lee ◽  
Dong Yeob Lee ◽  
Chan Shik Shim ◽  
Dae Hyeon Maeng

Object The purpose of the present study was to evaluate the efficacy of anterior polymethylmethacrylate (PMMA) cement augmentation in instrumented anterior lumbar interbody fusion (ALIF) for patients with osteoporosis. Methods Sixty-two patients with osteoporosis who had undergone single-level instrumented ALIF for spondylolisthesis and were followed for more than 2 years were included in the study. The patients were divided into 2 groups: instrumented ALIF alone (Group I) and instrumented ALIF with anterior PMMA augmentation (Group II). Sixty-one patients were interviewed to evaluate the clinical results, and plain radiographs and 3D CT scans were obtained at the last follow-up in 46 patients. Results The mean degree of cage subsidence was significantly higher in Group I (19.6%) than in Group II (5.2%) (p = 0.001). The mean decrease of vertebral body height at the index level was also significantly higher in Group I (10.7%) than in Group II (3.9%) (p = 0.001). No significant intergroup differences were observed in the incidence of radiographic adjacent-segment degeneration (ASD) or in terms of pain and functional improvement. The incidences of clinical ASD (23% in Group I and 10% in Group II) were not significantly different. There was 1 case of nonunion and 3 cases of screw migration in Group I, but none resulted in implant failure. Conclusions Anterior PMMA augmentation during instrumented ALIF in patients with osteoporosis was useful to prevent cage subsidence and vertebral body collapse. In addition, PMMA augmentation did not increase the nonunion rate and incidence of ASD.


2004 ◽  
Vol 23 (8) ◽  
pp. 413-419 ◽  
Author(s):  
Cetin Kaymak ◽  
Ela Kadioglu ◽  
Hulya Basar ◽  
Semra Sardas

In this study, genotoxic effects of repeated sevoflurane anaesthesia were investigated in rabbits with or without antioxidant supplementation. Twenty-one New Zealand male rabbits were included in the study and randomized into three groups as: placebo treated (Group I), vitamin E supplemented (Group II) and selenium supplemented (Group III). Vitamin E and selenium were given intraperitoneally for 15 days before anaesthesia treatment. Anaesthesia was administered using 3% sevoflurane in 4 L/min oxygen for a 3-hour period and continued for 3 days. Blood samples were collected before anaesthesia (Sample 1), after the first, second and third days of sevoflurane administration (Sample 2, Sample 3 and Sample 4 respectively) and the last samples were taken 5 days after the last sevoflurane administration (Sample 5). Genotoxic damage was examined using the comet assay. The degree of damage is assessed by grading the cells into three categories of no migration (NM), low migration (LM) and high migration (HM) depending on the fraction of DNA pulled out into the tail under the influence of the electric field. The number of comets in each sample was calculated (1 × number of comets in category NM + 2 × number of comets in category LM + 3 ×number of comets in category HM) and expressed as the total comet score (TCS), which summarizes the damage frequencies. In Group I, a significant increase in the mean TCSs was observed for Samples 3 and 4 as compared with Sample 1. However, there were no significant differences between Samples 1, 2 and 5. The mean TCS of Sample 4 was significantly higher than Sample 1, 2 and 3 in Group II. Group III demonstrated no significant mean TCSs for any experimental conditions. Statistical differences were also observed between the groups with significant P values. This experimental study points out the presence of DNA damage with repeated sevoflurane anaesthesia and the genoprotective role of antioxidant supplementation on DNA damage in mononuclear leukocytes of rabbits by highly sensitive comet assay.


2017 ◽  
Vol 22 (6) ◽  
pp. 56-60 ◽  
Author(s):  
Carla Y. Kong-Zárate ◽  
Marcos J. Carruitero ◽  
Will A. Andrews

ABSTRACT Objective: The purposes of this investigation were to determine the horizontal distances between the mandibular posterior teeth and the WALA ridge in a sample of Peruvians with normal occlusion and to compare them by tooth type, sex, arch side, and age groups. Methods: 65 dental casts of subjects with normal occlusion were collected. Posterior teeth, except for third molars, were evaluated. The horizontal distances between the occluso-gingival midpoints of the buccal surfaces (FA points) of each tooth and the WALA ridge were measured using a modified digital caliper. The values between each different tooth type within the sample were compared using the ANOVA and Scheffe tests, while comparisons by sex, arch side and age groups, using the Student’s t-test. Results: The mean distances in the sample was 0.96 mm for first premolars, 1.45 mm for second premolars, 2.12 mm for first molars and 2.55 mm for second molars. Statistically significant differences between each of the four tooth types were found. There were no significant differences found between sex, arch side and age groups. Conclusion: The horizontal distances between the mandibular posterior teeth and the WALA ridge increased progressively from the first premolars to the second molars in Peruvians with normal occlusion. The WALA ridge was a good landmark to evaluate the positions of posterior teeth in Peruvians with normal occlusion.


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