Comparison of Post-Operative Pain Between Nalbuphine and Tramadol in Total Intravenous Anesthesia for Dilation and Evacuation

2021 ◽  
Vol 15 (8) ◽  
pp. 2132-2133
Author(s):  
Quratulain Yunus ◽  
Saima Abdullah ◽  
Sana Riffaat
Keyword(s):  
Pain Score ◽  
Rapid Sequence Induction ◽  
Total Intravenous Anesthesia ◽  
P Value ◽  
Intravenous Anesthesia ◽  
Post Operative Pain ◽  
Rapid Sequence ◽  
Significant Difference ◽  
Sequence Induction ◽  
Group B

Objective: Comparison of post-operative pain between nalbuphine and tramadol in total intravenous anesthesia for dilation and evacuation. Methodology: This randomized controlled trial was conducted at Fatima Memorial Medical and Dental College and Hospital, Lahore during June 2019 to September 2020. We randomly enrolled in Two Groups-A, who received intravenous injection tramadol 1.5 mg/kg after rapid sequence induction with propofol2mg/kg, succinylcholine 1-1.5mg/kg followed by LMA insertion and Group-B those receiving nalbuphine0.1mg/kg after rapid sequence induction with propofol2mg/kg, succinylcholine 1-1.5mg/kg followed by LMA insertion. Consultant anesthetist administered these drugs and evaluated pain score after 30 mins of surgery done with the help of VAS. Results: Comparison of mean pain score in both groups shows 2.28+1.13 pain on VAS in Group-A and 1.07+0.82 in Group-B, p value was 0.0001 showing a significant difference. (Table 1) Conclusion: Post-operative pain is significantly lower in nalbuphinewhen compared with tramadol in total intravenous anesthesia for dilation and evacuation. Keywords: Dilation and evacuation, postoperative pain, nalbuphine, tramadol

scholarly journals Comparison of Rocuronium and Succinylcholine for Rapid Sequence Induction in patients undergoing surgery under General Anaesthesia

2020 ◽  
Vol 24 (2) ◽  
pp. 134-138
Author(s):  
Fasial Wahid ◽  
Aftab Hussain ◽  
Faiz Ur Rahman ◽  
Obaid Ur Rahman
Keyword(s):  
General Anesthesia ◽  
Randomized Control Trial ◽  
Rapid Sequence Induction ◽  
Rapid Sequence ◽  
Study Results ◽  
Sequence Induction ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Intubation Condition

Objectives: To compare the frequency of excellent intubation condition with Succinylcholine and rocuronium for rapid sequence induction in patients undergoing surgery under general anesthesia. Design: Randomized control trial. Place and duration of study: Department of anesthesiology and pain medicine, Combined Military Hospital Malir Cantt Karachi from 25th June to 10th August 2019. Methodology: In this randomized control trial, a non-probability consecutive sampling technique was used. Anesthesia was given through a standard approach. Then patients were randomly divided into two equal groups. In group A, succinylcholine (1mg/Kg) was given while in group B, rocuronium (1mg/Kg) was given. Laryngoscopy was attempted after 60 seconds. Intubating conditions were labeled as excellent, good, poor, and impossible. All the data was collected in two groups, the data was entered and analyzed on SPSS version 21. Results: The mean age of the patients was 40.11±9.49 years. The male to female ratio of the patients was 0.7:1. The study results showed the excellent intubation conditions were noted in 11 from group A and 9 from group B, good intubation condition was noted in 29 from group A and 25 from group B, poor conditions were noted in 17 from group A and 16 from group B and the impossible intubation conditions were noted in 13 from group A and 20 from group B. Statistically insignificant difference was found between the study groups with intubation conditions i.e. p-value=0.570. Conclusion: It has been proved in our study that both the succinylcholine and rocuronium are statically equally effective in terms of excellent intubation conditions in the management of rapid sequence induction in patients undergoing surgery under general anesthesia.

scholarly journals TRANSVERSUS ABDOMINAL PLANE BLOCK

2018 ◽  
Vol 25 (07) ◽  
pp. 1073-1077
Author(s):  
Syed Aftab Haider ◽  
Atqua Sultan ◽  
Zaira Salman ◽  
Salman Waris
Keyword(s):  
Pain Score ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
University Hospital ◽  
P Value ◽  
Tap Block ◽  
Rescue Analgesia ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group B

Objectives: To determine the efficacy of co-administration of magnesiumsulphate (MgSO4) with bupivacaine in enhancing the analgesic efficacy of Transversusabdominus plane block (TAP block) in patients undergoing total abdominal hysterectomy.Study Design: Randomized clinical single blinded trial. Setting: Department of Anesthesia,Nishtar Medical University/Hospital Multan. Period: 07 months from March 2017 to October2018. Methods: We included female patients who presented with uterine or ovarian cancer andplanned for total abdominal hysterectomy. In group B patients (n=30) TAP block was givenusing 0.25% bupivacaine (20 ml). In group M patients (n=30), 19.4 ml 0.25% bupivacaine plus0.60 ml Mg sulphate. Mean arterial blood pressure, heart rate, VAS pain score and time of1st rescue analgesia and total dose of rescue analgesia was noted in all patients. For dataanalysis we used independent sample t-test (Mann-Whitney U test for skewed data) to comparequantitative variables. Chi-square test we used for comparison of ASA status. P-value < 0.05was taken as significant difference. Results: Mean VAS pain score after 1 hour was 3.27+1.70in group B and 2.23+1.35 in group M (p-value 0.012), after 2 hours mean VAS pain score was4.03+2.10 in group B and 2.47+1.25 in group M (p-value 0.001), after 6 hours mean VAS scorewas 4.53+2.62 in group B and 3.27+1.36 in group M (p-value 0.02). Mean VAS pain score after12 and 24 hour of shifting the patient in recovery room was no significantly different between thegroups (p-value 0.55 & 0.08 resp.). Mean time of 1st rescue analgesia was 7.53+4.92 hours ingroup B versus 13.96+2.25 hours in group M. Conclusion: Administration of 200 mg of MGSO4with bupivacaine for TAP block significantly improves the duration of analgesia and reduces therequirement of rescue analgesics in patients undergoing total abdominal hysterectomy.

scholarly journals Comparison of rapid sequence induction intubation conditions with Suxamethonium verses Rocuronium.

2020 ◽  
Vol 27 (04) ◽  
pp. 759-764
Author(s):  
Aisha Ahmad ◽  
Samina Aslam ◽  
Amna Tariq ◽  
Robina Firdous ◽  
Humaira Ahmad ◽  
...  
Keyword(s):  
Cricoid Pressure ◽  
Controlled Trial ◽  
Rapid Sequence Induction ◽  
Induction Agent ◽  
Rapid Sequence ◽  
Sequence Induction ◽  
Group A ◽  
Random Number Table ◽  
Group B ◽  
Agent Group

Objectives: To compare endotracheal intubating conditions in rapid sequence induction using Suxamethonium and Rocuronium. Study Design: Randomized Controlled Trial. Setting: Allied Hospital Faisalabad. Period: From 02-07-2015 to 01-07-2016. Material & Methods: After taking approval from hospital ethical committee, cases of emergency surgery fulfilling the inclusion criteria were enrolled and informed consent was taken after explaining all the procedure to the patient. All the patients were randomly divided into 2 groups by using computer generated random number table. Both groups were induced with thiopentone sodium 5mg/kg, analgesia was given with nalbuphine 0.1mg/kg. Group A was given Suxamethonium in a dose of 1 mg/kg body weight after induction agent. Group B was given 0.6 mg/kg Rocuronium after induction. Intubation was performed after 60 sec in both groups with cricoid pressure. Anesthesia was maintained with O2/N2O in a ratio of 50:50 and isoflurane (0.6-1.0%) in both groups. Anesthesia was stopped at the end of surgery in all the patients. Results: Mean age of the patients was 40.49+11.47 and 43.43+12.88 years, 51.43% and 45.71% were male while 48.57% and 54.29% were females, Comparison of intubation conditions was recorded as 97.14% excellent and 2.86% good in patients received suxamethonium and 82.86% and 17.14% in Rocuronium Group had good conditions. Conclusion: It was found that Suxamethonium is significantly better when compared to Rocuronium for endotracheal intubation conditions in rapid sequence induction.

P91 Post-operative pain in neurosurgery

2019 ◽  
Vol 90 (3) ◽  
pp. e46.1-e46
Author(s):  
PM Haigh ◽  
F Al-Hatimi ◽  
H Stewart ◽  
S Rajagopal ◽  
S Khalifa ◽  
...  
Keyword(s):  
Pain Score ◽  
Spinal Surgery ◽  
Foramen Magnum ◽  
P Value ◽  
Inflammatory Agent ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean

ObjectivesAre the analgesic guidelines for those neurosurgical operations associated with major and complex major pain consistently followed? Is there a correlation between adherence and post-operative pain?DesignPatients undergoing spinal surgery and foramen magnum decompressions were visited on the first post-operative day (D1). They provided their pain score subjectively (0=nil; 10=worst ever experienced); objectively we recorded whether they could move in/out of bed without pain limitation.Subjectsn=57 consecutive patients undergoing elective major and complex major pain neurosurgery between April and June 2018 at the NHNN, Queen Square.MethodsA proforma was completed on D1. The patients consented to take part and answered three questions. We examined what (if any) analgesics they were admitted on, and what had been prescribed to cover the post-operative period. This was compared against the appropriate guideline for that category of operation.ResultsGuidelines were only followed in 16/57 (28.1%) cases; not followed in 41/57 (71.9%). On an unpaired T-test: 2-tailed P value=0.0195. Where guidelines were followed, the mean pain score reported was: 3.75 (SD 2.72) Where not followed, the mean pain score was 5.46 (SD 2.29). So with a 95% confidence interval −3.41 to −0.29, there is a significant difference between the pain in those prescribed according to the guidelines and those that were not.ConclusionsThe pain guidelines are not routinely followed. Most commonly this was due to no prescription for a non-steroidal anti-inflammatory agent. We suggest regular sessions of education of the guidelines. Cycle 2 closed the loop of the audit. We re-reviewed adherence and pain scores and found guidelines were followed in 34% of cases, which represented a 6% improvement. On a paired two-tailed P value=0.0794. The mean pain score where guidelines were followed=3.42 (SD1.62) against a mean=4.74 (SD 1.89) where guidelines were not followed.

Role of Aminophylline Intravesical Instillation on Enhancing Ureteral Dilatation prior to Ureteroscopy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Saafan ◽  
Mohamed Ismail Shabayek ◽  
Marwa Mamdouh Mohamed ◽  
Mostafa Mabrouk Bayomi Ali
Keyword(s):  
Intravesical Instillation ◽  
Controlled Study ◽  
P Value ◽  
Pressure Monitor ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Ureteral Dilatation ◽  
Group B

Abstract Background Semi-rigid uretroscopy (URS) is a common intervention approach for lower ureteric stones. Ureteral dilatation is frequently needed before URS to enable ureter accessing. Aminophylline is known by its muscle relaxant effect and has been suggested to be effective in ureteral dilation. Objectives To evaluate the effect of intravesical administration of aminophylline on ureteroscopy and to measure intraureteral pressure Methods This prospective randomized controlled study included 50 before and after aminophylline injection. patients with lower ureteral calculi. In group A, the ureter was dilated by intravesical aminophylline whereas in group B balloon dilator was used. Intraureteral pressure was measured using pressure transducer connected to invasive pressure monitor. Results No statistically significant difference was noticed between both groups in operative time, intra operative complication, need for ureteral stenting or stone free rate. However, post-operative pain and haematuria were statistically significantly higher among balloon group compared to aminophylline group. In group A, there was statistically significant decrease in intraureteral pressure after injection of aminophylline (7.80 ± 1.71) compared to before injection (12.2 ± 1.85) with p-value &lt; 0.001. Conclusion Aminophylline is effective in ureteral dilatation when intravesically injected with less frequent post-operative pain and hematuria.

scholarly journals Outcome of thyroid lobectomies undergone with and without drains

2020 ◽  
Vol 8 (8) ◽  
pp. 2919
Author(s):  
Sahrish Bachani ◽  
Shahid N. Memon ◽  
Muhammad R. Pathan ◽  
Rehmat Sehrish Shah ◽  
Aneeta Kumari ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Pain Score ◽  
Thyroid Nodules ◽  
University Hospital ◽  
P Value ◽  
Thyroid Lobectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Thyroid lobectomy is a common operative technique of management of benign solitary thyroid nodules in which drains are used routinely. Objective of this study to compare the outcome of thyroid lobectomies undergone with and without drains in patients of benign solitary thyroid nodules.Methods: A comparative cross-sectional research was completed on 98 patients of benign solitary thyroid nodules at surgery department of Liaquat University Hospital Jamshoro. Patients having age of 18-60 years underwent thyroid lobectomies were included and distributed in two groups A and B. Group A includes thyroid lobectomies with drain and Group B without drain. Postoperative outcomes including pain score assessed via visual analog score (VAS), hospital stay and complications including wound infection, seroma and hematoma.Results: Out of 98 cases, 49 underwent thyroid lobectomy with drain and 49 without a drain. Females patients were in majority in group A 42 (85.7%) and also in group B 47 (95.9%). No significant difference (p-value=0.674) was in mean age of group A 30.8±10.2 years and group B 31.8±12.2 years. Higher mean with significant difference (p-value=0.001) was in pain score of group A 5.61±1.25 as compared to group B 3.55±0.70. No significant difference was in complications; seroma 1 (2.04%) vs 5 (10.20%), hematoma 1 (2.04%) vs 1 (2.04%) and infection 3 (6.12%) vs 0 (0.0%) in group A and B respectively. Higher mean with significant difference (p-value=0.001) was in hospital stay of group A 2.40±1.57 days as compared to group B 1.42±0.54 days. No significant difference (p-value=0.748) was in overall rate of complications in group A 5 (10.20%) and B 6 (12.24%).Conclusions: Thyroid lobectomy with drain is not effective in lowering the postoperative complications whereas enhanced the risk of postoperative pain, wound infection and duration of hospital stay as compared to thyroid lobectomy without a drain.

scholarly journals COMPARATIVE EVALUATION OF POST-OPERATIVE PAIN BETWEEN CONVENTIONAL LAPAROSCOPIC CHOLECYSTECTOMY & SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Sanjay Kumar ◽  
Ashok Kaundal ◽  
Suneet Katoch
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Score ◽  
Single Incision ◽  
P Value ◽  
Conventional Laparoscopic Cholecystectomy ◽  
Conventional Laparoscopic ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Single Incision Laparoscopic Cholecystectomy

AIM: Comparative analysis of post-operative pain between Single Incision Laparoscopic Cholecystectomy and conventional Laparoscopic Cholecystectomy. Method: Patients suffering from symptomatic cholelithasis were randomly subjected to Single Incision Laparoscopic Cholecystectomy (SILC) and conventional four ports Laparoscopic Cholecystectomy (cLC). Data analyzed included duration of surgery, post-operative pain, For assessment of post-operative pain numeric pain scale scoring system was used and pain scoring done at four hours, twelve hours and twenty-four hours post-operatively. Results: The study included fifty patients operated upon from June, 2014 to May, 2014. Twenty-five patients were subjected to SILC and rest of the twenty-five underwent cLC. Pre-operative characteristics of two groups were similar and there was no significant difference between two groups based on age, sex and Body Mass Index. Post-operative pain score was higher for cLC compared to SILC at four, twelve and twenty-four hours post-operatively. The mean pain score at four hours was 4.64 ± 1.89 for SILC versus 7.72 ± 0.84 for cLC (p-value < 0.0001). While the score at twelve and twenty-four hours were 2.96 ± 1.88 and 1.80 ± 1.44 for SILC compared to 5.08 ± 1.15 and 3.80 ± 1.11 for cLC respectively. Conclusion: SILC is superior to cLC compared to post-operative pain as per our study. Keywords: SILC, cLC, post-operative pain

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.

A Study of The Effect of Aminophylline on Clinical Recovery and Bis Readings After Total Intravenous Anesthesia

2021 ◽  
pp. 6012-6016
Author(s):  
Ghison I. Kadhim
Keyword(s):  
Recovery Time ◽  
Total Intravenous Anesthesia ◽  
Orthopedic Procedures ◽  
P Value ◽  
Skin Closure ◽  
Intravenous Anesthesia ◽  
Extubation Time ◽  
Significant Difference ◽  
Group A ◽  
Eye Opening

Background: In anesthesia and intensive care we face a lot of respiratory problems that require the use of bronchodilators such as aminophylline which is accused of antagonizing of the action of adenosine which acts as neuromodulator in the CNS. Objective: To test the hypothesis that aminophylline increases BIS readings and decreases recovery time after total intravenous anesthesia. Methods: We tested the hypothesis on 50 patients who were to be operated upon for orthopedic procedures. We induced anesthesia using bollous dose of propofol 2.5 mg/kg and bollous remifentanil 1.5 mcg/kg and didn't use any muscle relaxant. Anesthesia was maintained using propofol and remifentanil infusion in the rate of 100 mcg/kg/min and 0.2 mcg/kg/min respectively with 100% O2 with BIS readings in the range of 40 – 60. After skin closure, patients were divided into group A (given aminophylline 4 mg/kg), and group P (given same volume of normal saline). Vital signs and BIS values were recorded. Time to eye opening and extubation time and time to reach BIS value of 95 were measured. Results: Significant difference was found in BIS readings (p value < 0.001). Time to eye opening and extubation times were significantly shorter in group A than group P (p value < 0.001). Conclusion: Aminophylline decreases recovery time and increases BIS readings after TIVA.

scholarly journals Effect of Bispectral Index-Guided Total Intravenous Anesthesia on Post-Anesthetic Recovery Outcomes in High-Risk Children: A Prospective, Randomized, Controlled Trial

2021 ◽  
Author(s):  
Guoliang Liu ◽  
Lijing Li ◽  
Xuemei Zhang ◽  
Xiaoxue Wang ◽  
Lei Hua ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Bispectral Index ◽  
Controlled Trial ◽  
Total Intravenous Anesthesia ◽  
Depth Of Anesthesia ◽  
Intravenous Anesthesia ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
Group B

Abstract BACKGROUND TIVA is widely used in children, but few studies have attempted to evaluation of the effect of BIS-guided propofol infusion than that on conventional methods on recovery outcomes in children with higher risk factors.OBJECTIVETo evaluate the effect of bispectral index (BIS) guidance during total intravenous anesthesia on post-anesthetic recovery outcomes in children at higher risk during anesthesia. DESIGNA prospective, randomized, controlled trial. SETTING University medical centre.PATIENTSThis study enrolled 472 children (aged 1-14 years) who met the higher-risk scoring criteria and were scheduled for surgery under total intravenous anesthesia. INTERVENTIONThe children were randomly assigned to the BIS group (group B) and standard clinical practice group (group S). The BIS values in group B were maintained at 45–60. The anesthesiologist controlled the depth of anesthesia in group S according to the variation in the clinical signs of the children. MAIN OUTCOME MEASURESBIS values, heart rate (HR), mean arterial pressure (MAP), and pulse oxygen saturation at each time points, as well as the time between drug withdrawal to extubation, duration of stay in the post-anesthesia care unit (PACU), the total amount of propofol used, and postoperative adverse reactions were recorded. RESULTSThere was no significant difference in time from stopping propofol infusion to extubation and duration of PACU between the groups . There was no significant difference in BIS values between the groups at T2, T3, and T8. BIS values at T1, T4, T5, T6, and T7 in group B were lower than those in group S. There was no statistically significant difference in the HR between the groups. MAP in group B was lower than in group S at T5, T6, T7, and T8. The total amount of propofol administered in group B was higher than in group S. CONCLUSIONThe use of BIS-guided total intravenous anesthesia in higher-risk children can maintain the proper depth of anesthesia but does not prolong the time of extubation and the duration of stay in the PACU.TRIAL REGISTRATION Chictr.org.cn identifier: 24/11/2017 , ChiCTR-IOR-17013530

Sign in / Sign up

Export Citation Format

Share Document