Compare the Effectiveness of Hematoma Block versus Intravenously Sedation for Reduction of Colles Fracture

2021 ◽  
Vol 15 (8) ◽  
pp. 2519-2521
Author(s):  
Shah Hussain ◽  
Zahid Khan ◽  
Muhammad Habib Khan ◽  
Muhammad Gulzar Khan ◽  
Jamal Bahadar ◽  
...  
Keyword(s):  
Intravenous Sedation ◽  
Radiographic Assessment ◽  
Left Hand ◽  
Vas Score ◽  
Group I ◽  
Hand Fracture ◽  
Colles Fracture ◽  
Randomized Control ◽  
Group Ii ◽  
Written Informed Consent

Objective: To compare the effectiveness of hematoma block versus intravenous sedation in reduction of colles fractures. Study Design: Randomized control trial Place and Duration: Conducted at the Emergency department of Lady Reading Hospital Peshawar for duration of six months i.e January 2020 to June 2020. Methodology: One hundred and twenty patients of both gender presented with distal radius fracture were enrolled in this study. After taking written informed consent from all the patients’ detailed demographics including age, sex, BMI, site of fracture, cause of fracture and radiographic assessment were recorded. All the patients were equally divided into two groups. Group I (Hematoma Block) consist of 60 patients and group II (Intravenous Sedation) contains 60 patients. Pain was recorded on visual analogue scale VAS at the start and after procedure of reduction. Data was analyzed by SPSS 24.0. Results: Majority were females 40 (66.7%) in group I and 41 (68.3%) in group II and the rest were males 20 (33.3%) and 19 (31.7%). Mean age of the patients in group was 27.48±19.64 years with mean BMI 25.12±9.46 kg/m2 and in group II mean age was 26.72±9.48 years with mean BMI 24.48±17.61 kg/m2. In group I 35 (58.3%) had left side fracture while in group II 32 (53.3%) cases had left hand fracture. Falling was the most common cause of colles fracture found in 45 (75%) patients of group I and 42 (70%) patients in group II followed by accident 13 (21.7%) and 15 (25%) in group I and II. Before reduction means pain score by using VAS among both groups was 8.60±8.23 and 8.03±5.23, during induction mean VAS score reduced to 3.77.±5.42 and 3.09±4.44 and after reduction mean VAS score was lower in hematoma block 1.01.±2.22 as compared to group II 2.06.±4.14. Post-treatment complications were higher in group II as compared to group I. Conclusion: In this research we concluded that hematoma block is a safe and effective as compared to intravenous sedation for the decrease of colles fracture pain in patients. Keywords: Colles Fracture, Hematoma Block, Intravenous sedation, VAS, Pain Reduction

scholarly journals Comparison of Ropivacaine-Fentanyl with Bupivacaine-Fentanyl for Labour Epidural Analgesia

2020 ◽  
Vol 14 (1) ◽  
pp. 108-114
Author(s):  
Kalpana Kulkarni ◽  
Rahul Patil
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Epidural Analgesia ◽  
Diastolic Blood Pressure ◽  
Diastolic Pressure ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
Labour Epidural Analgesia ◽  
Group Ii

Background: Bupivacaine with opioid is commonly used for labour epidural analgesia. Ropivacaine is considered as an alternative to bupivacaine due to its lower cardiovascular complications. However, there is a controversy regarding the efficacy of these drugs as some studies suggest equivalent action, whereas others report that ropivacaine produces less motor blockade. The study aimed to compare the effect of ropivacaine-fentanyl and bupivacaine-fentanyl for labour analgesia. Materials and Methods: The prospective randomized study was performed on 60 parturients, divided into two groups of 30 subjects each. Group I received 10ml of bupivacaine 0.1% + fentanyl 2µg/ml and Group II received 10ml of ropivacaine 0.1% + fentanyl 2µg/ml by epidural catheter. Pre-anaesthetic evaluation was performed on all the participants and all were administered metoclopramide 0.25mg/kg and ondansetron 0.08-0.1mg/kg intravenously as premedication. The baseline and post anaesthesia systolic, diastolic blood pressure, heart rate, VAS score, degree of motor block, sedation and APGAR score of the baby were recorded. The data were tabulated and statistically analyzed. Results: When compared, there was no significant difference in systolic/diastolic blood pressure in two groups except at 360 min where diastolic pressure was low in group II. Significantly higher heart rate at 30 min (P=0.0003), 120 min (0.006), and 300 min (P=0.001) was observed in group I subjects. VAS score was significantly less at 180 min (P=0.019) and 300 min (P=0.019) in group II. Adverse effects such as fetal bradycardia, nausea/vomiting and hypotension observed were clinically insignificance when compared in two groups. Conclusion: Bupivacaine and ropivacaine produce an equal degree of analgesia and hemodynamic stability in 0.1% of concentration when added with 2µg/ml fentanyl . However, heart rate was well maintained with lower VAS scores in group II receiving ropivacaine. No significant difference in the side effects between the two groups. Hence, Ropivacaine can be used as a safe alternative to bupivacaine for labour epidural analgesia.

scholarly journals Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma
Keyword(s):  
Quality Of Life ◽  
Morphine Consumption ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Upper Abdominal

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.

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

Frequency of Post Dural Puncture Headache with Quincke 25g and Quincke 27g Spinal Needle after Spinal Anaesthesia

2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Chi Square ◽  
Post Dural Puncture Headache ◽  
Group I ◽  
Chi Square Test ◽  
Randomized Control ◽  
Group Ii ◽  
The Difference

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.

scholarly journals PREOPERATIVE KETOROLAC EFFECT ON POSTOPERATIVE PAIN ON TURP PATIENTS

2013 ◽  
Vol 20 (2) ◽  
Author(s):  
Choirul Hadi ◽  
Trisula Utomo
Keyword(s):  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Prostatic Hyperplasia ◽  
Transurethral Prostatectomy ◽  
Cross Sectional ◽  
Vas Score ◽  
Group I ◽  
Post Operative Pain ◽  
Group Ii

Objective: The aim of this study is to study the effect of preoperative Ketorolac on postoperative pain after transurethral prostatectomy at Sardjito Hospital Yogyakarta. Material & Methods: This is a cross sectional, analytic, prospective study. We divided benign prostatic hyperplasia patients, from October 2011 until February 2012 into two groups. Group I was given Ketorolac 30 mg intravenously twice daily starting one day before operation and in the morning before procedure. Group II did not receive Ketorolac preoperatively. Patients underwent transurethral operation with spinal anesthesia. We assessed postoperative pain at 24 hours using Visual Analogue Scale (VAS). Results: Twenty four patients were included in this study with mean age 66 years old with the youngest 45 years old and the oldest 80 years old (SD 8,77744). Group I (17 patients), VAS score 1 to 7 with median 3 and mean 3,4118 (SD 1,66053). Group II (7 patients) VAS score 1 to 8 with median 3 and mean 3,8571 (SD 2,8357). We count it using Mann-Whitney U (p = 0,951). Conclusion: There is no significance difference in post-operative pain after transurethral prostatectomy with preoperative ketorolac administration.Keywords: Ketorolac, bupivacaine, visual analogue scale, transurethral prostatectomy.

scholarly journals Comparison between Pendant Positions versus Traditional Sitting Positions for Successful Spinal Puncture in Patients Undergoing Caesarean Deliveries

2021 ◽  
Vol 15 (7) ◽  
pp. 1804-1806
Author(s):  
Noman Tariq ◽  
Shahid Rasool Dar ◽  
Khalid Abaidullah ◽  
Sunila Riaz
Keyword(s):  
Pregnant Women ◽  
Randomized Control Trial ◽  
Needle Insertion ◽  
Sitting Position ◽  
Spinal Puncture ◽  
Standard Position ◽  
Group I ◽  
Randomized Control ◽  
Group Ii ◽  
Better Than

Aim: To determine the effectiveness among pendant position and traditional sitting position in term of successful spinal puncture in patients underwent caesarean deliveries. Study Design: Randomized control trial Place and Duration of Study: Department of Anaesthesia, Ghurki Trust Teaching Hospital, Lahore from 1st April 2020 to 31st March 2021. Methodology: One hundred and eighty patients were included. Patient’s detailed demographics were recorded after taking written consent. Patients were aged between 20-50 years. Patients were equally divided into two groups, group I had 90 patients underwent pendant position and group II had 90 patients and underwent for traditional sitting. Randomly one of two positions was performed with the L3-L4 interface in spinal puncture. Time for successful spinal puncture, number of needle to bone contacts and total number of attempts were calculated. Results: Mean age of the patients in group I was 27.6±17.04 years with mean BMI 24.25±2.63 kg/m2 and in group II, mean age was 29.23±14.24 years with mean BMI 26.55±6.36 kg/m2. Mean height of patients in group I was 2.6524±1.0054 meter and in group II was 2.6516±1.0042 meter. Weight of the patients in group I 63.48±22.13 kg and in group II was 65.46±17.19 kg. Success rate after first attempt in group I was 80 (94.44%) and group II was 72 (80%). For spinal needle insertion, fewer mean times was observed in group I 19.55±11.221 sec as compared to group II 28.14±18.226 sec. Number of needle to bone contacts was higher 66.7% in group I and in group II 40%. Number of attempt was less in group I as compared to group II. Conclusion: The pendant position in the pregnant women who had a caesarean sector was much better than the standard position in order to provide the 1st attempt of spinal puncture. Keywords: Caesarean, Spinal anaesthesia, Traditional sitting, Pendant position

scholarly journals Comparison of intraperitoneal instillation of ropivacaine with normal saline in laparoscopic cholecystectomy

2017 ◽  
Vol 5 (11) ◽  
pp. 4924 ◽  
Author(s):  
Tripat Kaur Bindra ◽  
Davinder Chawla ◽  
Parmod Kumar ◽  
. Parul
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Side Effects ◽  
Double Blind Study ◽  
Analgesic Requirement ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Vas Score ◽  
Group I ◽  
Intraperitoneal Instillation ◽  
Group Ii

Background: Local anesthetics are now widely used, as they have a good safety profile and are available in long acting preparation. They provide the benefit of analgesia without systemic side effects that may result from use of enterally and parenterally administered drugs.Methods: This prospective randomized double-blind study was conducted on 100 patients with symptomatic gall stones disease undergoing laparoscopic cholecystectomy. Patients were randomized to receive either 0.5% of 3mg/kg of Ropivacaine diluted in 100 ml NS, instillation at intraperitoneal space before creation of pneumoperitoneum (group I) or 100 ml NS instillation at intra peritoneal space before creation of pneumoperitoneum (group II). VAS score for pain abdomen as well as shoulder were recorded postoperatively at various time intervals and compared in both the groups. Total analgesic consumption in 24hrs was also noted and compared.Results: The mean postoperative VAS score for abdomen and shoulder pain was significantly (p values<0.05) lower in group I than in group II till 24 hrs postoperatively. The latency time from end of operation to first analgesic requirement was significantly longer in group I than in group II.Conclusions: Intraperitoneal instillation of Ropivacaine before the creation of pneumoperitoneum significantly decreased the total abdominal pain, shoulder tip pain with lower analgesic consumption. As it is safe and without apparent side effects, we believe that intraperitoneal instillation of local anaesthetic in patients undergoing elective laparoscopic cholecystectomy is an effective modality for postoperative pain management.

scholarly journals Comparative evaluation of different volumes of 70% alcohol in celiac plexus block for upper abdominal malignsancies

2016 ◽  
Vol 05 (04) ◽  
pp. 204-209 ◽  
Author(s):  
Archana Dolly ◽  
Sarita Singh ◽  
Ravi Prakash ◽  
Jaishri Bogra ◽  
Anita Malik ◽  
...  
Keyword(s):  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Group Iii ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
Vas Scores ◽  
Group Ii ◽  
Upper Abdominal ◽  
Plexus Block

Abstract Context: Celiac plexus block (CPB) (is an effective way to reduce cancer-associated pain in upper abdominal malignancies. Aims: To evaluate the efficacy and safety of different volumes of 70% alcohol in CPB. Settings and Design: Prospective, randomized, controlled clinical study. Subjects and Methods: Thirty patients of carcinoma gall bladder were randomly divided into three groups (n = 10) to receive 20, 30, and 40 ml of 70% alcohol in CPB. Statistical Analysis Used: All the continuous data were assessed analysis of variance followed by post-hoc tests (Tukey′s Honestly Significant Difference test). Ordinal data were compared using Kruskal-Wallis H-test followed by Mann-Whitney U-test. Categorical comparisons were performed using Chi-square test. Results: A significant difference in visual analog scale (VAS) score of Group I, Group I and Group III was observed from week 6 onward until the end of the study. At all these time intervals, VAS scores in Group I was higher than both Groups II and III during this time interval. VAS scores in Group III were significantly lower as compared to Group II from week 10 onward until the end of the study. As compared to baseline, at all the follow-up intervals, mean morphine requirement was significantly lower in Group II and Group III. A quality of life (QOL) score of Group III were higher as compared to Group I. Between Group II and Group III, significant difference was observed at week 16 only when Group III had a higher score as compared to Group II. Conclusions: VAS score, QOL, and reduction in morphine consumption were increased on increasing the volume of alcohol in CPB, 40 ml being most effective.

scholarly journals Influence of Sedation with Dexmedetomidine on Oxidative Distress During Delirium Developed Following Severe Polytrauma

2019 ◽  
Vol 15 (4) ◽  
pp. 11-20
Author(s):  
F. F. Bershadsky ◽  
O. A. Grebenchikov ◽  
A. V. Yershov ◽  
V. V. Likhvantsev ◽  
M. A. Magomedov
Keyword(s):  
Blood Plasma ◽  
Cognitive Dysfunction ◽  
Clinical Efficacy ◽  
Combined Therapy ◽  
Intravenous Sedation ◽  
Group I ◽  
Polytrauma Patients ◽  
Group Ii

Purpose is to evaluate the influence of intravenous sedation with dexmedetomidine and propofol on the intensity of oxidative distress, delirium severity and duration in severe polytrauma patients.Material and methods. 100 victims (18 to 50 years of age, trauma of two regions and more, ISS score at admission equal to 16–50) were included in the study. Depending on sedation method, the patients were split into group I (n=51) and group II (n=49), in the combined therapy of whom propofol and dexmedetomidine were used, respectively. In addition to standard examinations, the blood plasma carbonylated peptides were assayed in all patients.Results. It has been established that the assay content of carbonylated peptides in blood might reflect polytrauma severity. A link between the oxidative distress intensity and delirium duration (r=0.34; P<0.05) and severity (r=0.38, P<0.05) in severe polytrauma patients has been demonstrated, which might support the role of oxidative distress in delirium development. Influence of the sedation drugs dexmedetomidine or propofol on oxidative distress intensity was not evident in all stages of the study.Conclusion. Significant oxidative distress promotes longer and more severe course of delirium in severe polytrauma patients. The content of carbonylated proteins over 0.78 nmol/mg predicts the development of cognitive dysfunction one month after severe polytrauma with 62% sensitivity and 67% specificity. In spite of clinical efficacy, neither dexmedetomidine nor propofol reliably reduce oxidative distress in severe polytrauma patients.

scholarly journals COMPARISON OF INTRATHECAL BUPIVACAINE WITH OR WITHOUT CLONIDINE FOR PERIOPERATIVE ANALGESIA IN LOWER LIMB ORTHOPEDICS SURGERIES

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr Rajit Kumar ◽  
Dr Shalendra Singh ◽  
Dr Sunny Eapen ◽  
Dr Raghavendra Kumar Giri ◽  
Dr Priya Taank ◽  
...  
Keyword(s):  
Optimal Dose ◽  
Sensory Block ◽  
Motor Blockade ◽  
Perioperative Analgesia ◽  
Vas Score ◽  
Group I ◽  
Prolonged Duration ◽  
Haemodynamic Changes ◽  
Group Ii ◽  
The Difference

Background: The newer adjutants for spinal anaesthesia (SA) have seen numerous modifications over the last two decades. Various doses of clonidine have been tried in past but optimal dose which balances the ill effects has to be discovered. Therefore, this study was designed to study the effect of clonidine as an adjuvant in SA in terms of duration and complication. Methods: Two groups I and II ( with 60 patients each)  received either 3.0 ml of Bupivacaine 0.5% heavy + 0.5 ml of normal saline and 2.5 ml of bupivacaine 0.5% heavy  + 0.5 ml (75µg) of preservative free clonidine respectively. Various haemodynamic parameters and complication were recorded at baseline than 30 min, 1,2,4,6 and 8 hours after SA. Results: Group II shows that addition of clonidine had altered the heart rate and blood pressure significantly for initial two hour duration(p<0.05). No difference in the onset of sensory and motor blockade in both groups. Majority of patients in both group had level of sensory block upto T7 level. Mean VAS score was significantly lower in group II (p<0.001). Group II has prolonged duration of motor blockade (p< 0.00l). The difference in mean duration of analgesia among both the groups was significant indicating that addition of clonidine prolongs the duration of analgesia (p<0.0001). In group II incidence of hypotension and bradycardia is more as compared to group I. Conclusion: Intrathecal clonidine in the dose of 75 µg along with bupivacaine 0.5% heavy prolonged postoperative analgesia and motor blockade. It produces sedation in which patients were asleep and easily arousal and haemodynamic changes which could be easily managed. Keywords: Intrathecal, Bupivacaine, Clonidine, Orthopedics surgeries, VAS score

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