Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

Efficacy of Ultrasound Guided Fascia Iliaca Block for Pain Management Compared to Conventional Pain Killers; A Comparative Study

2021 ◽  
Vol 15 (8) ◽  
pp. 2525-2528
Author(s):  
Muhammad Habib Khan ◽  
Shah Hussain ◽  
Muhammad Gulzar Khan ◽  
Jamal Bahadar ◽  
Muhammad Kashif ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Ultrasound Guided ◽  
Analog Scale ◽  
Patients Satisfaction ◽  
Satisfaction Rate ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Fascia Iliaca Block

Objective: The aim of this study is to determine the efficacy of ultrasound guided fascia iliaca block for pain management compared to conventional pain killers. Study Design: Place and Duration: The study was conducted at the emergency department of Lady Reading Hospital Peshawar for duration of six months i.e June 2019 to December 2019. Methods: Total 80 patients of both genders underwent for arthroplasty were presented in this study. Patients were aged between 40-80 years. Patients detailed demographics age, sex, weight and body mass index were recorded after taking informed written consent. Patients were divided into 2-groups. Group I had 40 patients and received fascia iliaca block while group II received conventional pain killers with 40 patients. Postoperative outcomes reduction in pain score was assessed by visual analog scale (VAS). Postoperatively complications and patients satisfaction was also observed and compared among both groups. Complete data was analyzed by SPSS 26.0version. Results: There were 22 (55%) male and 18 (45%) female patients in group I while in group II male patients were 21 (52.5%) and 19 (47.5%) were females. Mean age in group I was 57.17±10.21 years with mean BMI 26.64±3.54 kg/m2 and in group II mean age was 58.25±9.66 years with mean BMI 26.48±3.45 kg/m2. 25 (62.5%) patients had ASA I and 15 (37.5%) had II in group I but in group II 24 (60%) had ASA I and 16 (40%) had II. Post-operative after 48hrs pain score in group I was 2.03±3.18 lower as compared to group II 4.08±7.81. Frequency of complications was higher in group II 23 (57.5%) as compared to group I 8 (20%). Satisfaction among patients of group I was 34 (85%) higher as compared to group II 19 (47.5%). Conclusion: We concluded in this study that the use of anesthesia fascia iliaca block was effective in terms of pain reduction and fewer complications than conventional pain killers after arthroplasty. Except this satisfaction rate was also higher among patients who received FICB. Keywords: Fascia iliaca block, Pain killer, Arthroplasty, Pain, Complications

A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA

2021 ◽  
pp. 48-50
Author(s):  
Niraj Kumar Mishra ◽  
Sushil Kumar
Keyword(s):  
Side Effects ◽  
Fetal Distress ◽  
Labour Pain ◽  
Sampling Procedure ◽  
Chi Square ◽  
Double Blind ◽  
Motor Weakness ◽  
Group I ◽  
Group Ii ◽  
Fetal Oxygenation

Introduction: Labour pain is among the most severe pain a woman can experience in her lifetime. Painful labour has decrimental effects on both mother and fetus leads to severe physical and psychological stress. Maternal hyperventilation in response to pain reduces fetal oxygenation and hypoventilation between contractions combined with decreased blood ow worsens fetal hypoxemia. It has been suggested that conning women to bed during labour may cause the labour to be longer and more painful with increase in abnormal presentation, instrumental deliveries and fetal distress. Aims And Objectives:The onset, quality and duration of their analgesic action. Incidence of unwanted effects like muscle weakness, hypotension, pruritus, nausea/vomiting, fetal bradycardia by the individual drugs. Materials And Methods: The study was conducted in the department of anesthesia, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Methods of collection of data (including sampling procedure if any) : After institutional committee approval and written informed consent from parturients and their relatives for the procedure the study was conducted and data were collected. Results: Duration of analgesia was found varying widely. It was 55±12.34 minutes in Group I whereas 75 ±14.36 minutes in Group II. The incidence of pruritus almost mild or negligible in both groups. The incidence of motor weakness in group II was 24 (80%) whereas in group I it was 10(33%). There was signicant statistics difference in motor weakness between two groups (p< 0.001) by Chi square test 9 with yate's correction. Other side effects differences between two groups were not statistically signicant. Summary And Conclusion:Both the drugs provided excellent quality of analgesia to the parturient in pain. The difference in duration of analgesia was signicant between the two groups statistically. Mean duration of analgesia lasted for 55 minutes in group I whereas in group II, it lasted for 75 minutes. Main side effects encountered in this study were motor weakness of longer duration in group II than in group I. Other side effects like nausea-vomiting were comparable to each other and were minimal in nature.

scholarly journals A Seven-year Follow-up Study of Patient Satisfaction with Three-implant-retained Mandibular Overdentures

2021 ◽  
Vol 9 (D) ◽  
pp. 103-107
Author(s):  
Hisham Samir ElGabry
Keyword(s):  
Long Term Results ◽  
Complete Dentures ◽  
Patients Satisfaction ◽  
Follow Up Study ◽  
Group I ◽  
Significant Difference ◽  
Male Patients ◽  
Group Ii ◽  
Anterior Mandible

PURPOSE: This study aimed to compare patients’ satisfaction with mandibular overdentures retained by three-splinted implants versus conventional complete denture wearers during a 7-year follow-up study period. MATERIALS AND METHODS: Thirty edentulous male patients (mean age: 60 years) were carefully selected and divided into two equal groups. All patients received a new set of complete dentures. Group I patients received three implants in the anterior mandible and were connected after 3 months with bars, clips, and loaded. Group II patients received conventional complete dentures. Patients’ satisfaction was recorded for both groups at 3 weeks (baseline) and after 1, 3, 5, and 7 years. Patients were then asked to grade their overdentures/dentures on a visual analog scale and written questionnaire to evaluate their overall satisfaction. RESULTS: Satisfaction scores of Group I patients were found to be statistically significantly higher than that of Group II patients (p < 0.05) at 3, 5, and 7 years follow-up, meanwhile, no statistically significant difference was found at baseline or after 12 months. CONCLUSION: The long-term results suggest that three-implant-retained mandibular overdenture with a clip-bar attachment appears to be a successful rehabilitation strategy which is superior to conventional dentures for patients with advanced ridge resorption.

scholarly journals A clinical comparison of high dose and low dose of Suxamethonium

2014 ◽  
Vol 9 (2) ◽  
pp. 1-8
Author(s):  
RK Yadav ◽  
PC Majhi ◽  
D Tiwari
Keyword(s):  
Intraocular Pressure ◽  
Dose Group ◽  
Low Dose ◽  
Cardiovascular Responses ◽  
High Dose ◽  
Clinical Effects ◽  
Duration Of Action ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Suxamethonium having its rapid onset and short duration of action makes this drug unique amongst the neuromuscular blocking drugs described so far. However, use of suxamethonium is associated with a large number of undesirable side effects. Objective: To evaluate clinical effects of high and low dose of suxamethonium and to determine whether lower dose of suxamethonium can be used for any beneficial effects in terms of its various adverse effects e.g. cardiovascular responses, post-operative muscle pains and intraocular pressure. Methods: A total of 100 patients were included in this prospective study. All these patients on preoperative clinical evaluation were assessed to have adequate airway. All the patients were divided in two groups, low dose group (group I) and High dose group (group II) with 50 patients in each at random. A standard anesthetic technique was adhered to all the patients and following parameters were observed on comparative basis: a. Fasciculation and post operative myalgia. b. Cardiovascular effects, c. Intraocular pressure. Observation: The incidence of post Suxamethonium pain was significantly greater in group II. Increase in heart rate from baseline was significant in both groups. There was no significant difference between the two groups in the diastolic pressure but rise in systolic blood pressure was significant at all assessment times in both groups. This rise from control was statistically significant. Conclusion: Suxamethonium can be used in lower doses (0.5 mg/kg) in elective cases without airway compromise. It gives benefits of reduced muscle pains, cardiovascular responses and intraocular hypertension. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9677

Comparison of the effectiveness of antibacterial therapy regimens in the treatment of asymptomatic bacteriuria during pregnancy

2018 ◽  
pp. 57-60
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Bacterial Infection ◽  
Asymptomatic Bacteriuria ◽  
Urine Specimen ◽  
Cultural Research ◽  
Group I ◽  
Group Ii ◽  
American Society ◽  
Practical Recommendations

The objective: to evaluate the effectiveness of the proposed therapy in pregnant women with asymptomatic bacteriuria. Materials and methods. All patients were divided into two groups. І group – 38 patients received the course of amoxicillin with clavulanic acid 625 mg per os twice a day for 7 days, group II – 33 patients received D-mannose (1.2 g), powder of 5.8 g in a sachet 2 times a day for 7 days. Diagnostic criteria for asymptomatic bacteriuria were based on practical recommendations of the American Society of Infectious Diseases. Results. In the first cultural research of the urine specimen (immediately after the end of the course of therapy), the percentage of microorganism’s persistence in the urinary tract of a woman was determined, in case of its detection, an additional course of treatment was prescribed. In the second and subsequent control urine samples, the percentage of relapsing bacteriuria was determined. Percentage of the persistence of the pathogen in the urinary tract among the treated women with bacteriuria remained rather low – 10.5% (4 patients) in group I, but higher than in group II 3.1% (1 patient). The percentage of sterile first urine sample was high and probably did not differ between groups – 31 (81.6%) and 32 (96.9%) women respectively in I and II groups. In the first group, the percentage of relapses during gestation after the diagnosed and treated bacteriuria remained rather high and amounted to 23.7% (9 patients), and in the second group, the relapse was not recorded. Conclusions. The 7-day course of therapy with the D-mannose drug is associated with fewer cases of persistent pathogenic pathogens in urine, no recurrence of bacterial infection, and no side effects. Key words: asymptomatic bacteriuria, D-mannose, urinary tract, pregnancy.

scholarly journals Simultaneous saline irrigation during retrograde rigid ureteroscopic lasertripsy for the prevention of proximal calculus migration

2013 ◽  
Vol 7 (1-2) ◽  
pp. 65 ◽  
Author(s):  
Lu Sun ◽  
Fang-li Peng
Keyword(s):  
Operative Time ◽  
Upper Urinary Tract ◽  
Excretory Urography ◽  
Ureteral Stones ◽  
Saline Irrigation ◽  
Irrigation Method ◽  
Group I ◽  
Significant Difference ◽  
Stone Migration ◽  
Group Ii

Objective: To analyze the clinical efficacy of Simultaneous saline irrigation method in treating upper-mid ureteral stone migration and overall efficiency during ureteroscopic lasertripsy. Methods: We prospectively evaluated 78 patients with a total of 95 upper-mid ureteral stones, which were treated with holmium: YAG lasertripsy. These patients were randomized into two groups. In group I (39 cases with 44 ureteral stones), conventional ureteroscopic lasertripsy was performed in like manner. While in group II (39 cases with 51 ureteral stones), the Simultaneous saline irrigation method was used during lasertripsy. There was no significant difference between the groups with regards to stone site, size or state of the upper urinary tract by spiral computed tomography or excretory urography. Data were analyzed regarding stone migration, lengths of time, and ureteral clearing for various stages of each procedure. Results: One patients (2%) occurred upward stone migration in group II, while in group I it occurred in eight patients (20%).The operative time in group I ranged between 35 to 55 minutes (mean, 44.8±5.3), while in group II it ranged between 40 to 69 minutes (mean, 50.4±3), The operative time was no significant difference between the groups  (p<0.05). Ureteral perforation, urinoma, and urosepsis were not seen in both groups. Conclusion：Simultaneous saline irrigation method demonstrated a statistically significant advantage over the conventional methods. Operation can be performed persistently under clear vision, and the calculus can not be moved upwards, the fragmentation easily to be flushed out. Our data suggest that this method is simple，safe and effective in preventing proximal stone migration during ureteroscopic lasertripsy.

scholarly journals A comparative clinical study of intrathecal hyperbaric bupivacaine with and without fentanyl for hysterectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 59-63
Author(s):  
Hari Poudel ◽  
Surinder Nath Bawa ◽  
Surendra Mohan Sharma
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Maximum Height ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Spinal anaesthesia has been widely used for lower abdominal surgeries like hysterectomy.Hyperbaric bupivacaine is the most extensively used local anesthetic. Addition of fentanyl can allow the reduction in the dose of bupivacaine, increase the height and duration of sensory blockade, and reduces complications of spinal anesthesia. Aims and Objective: The aim of the study was to examine whether adding fentanyl to hyperbaric bupivacaine would increase the height of sensory blockade, accelerate the onset of sensory blockade and increase the duration of the sensory blockade. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal that included hundred patients who underwent total abdominal hysterectomy. The patients were randomly allocated in two groups; Group I: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus normal saline 0.5 ml. Group II: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus 0.5 ml fentanyl (25 μg). Hemodynamic variables, onset of motor and sensory blockade, duration of sensory and motor blockade and any side effects were observed and recorded. Results: The highest and lowest sensory block in Group I was T-7 and T-9 whereas in Group II was T-5 and T-9 respectively. In group I, the mean onset till maximum height of sensory blockade was 7.04 min whereas in group II it was 5.96 min (P<0.00).There was no significant statistical difference in the incidence of side effects in both the groups. Conclusion: Intrathecal fentanyl with hyperbaric bupivacaine for spinal anesthesia significantly accelerated the onset of sensory blockade and increased its maximum height and duration.

scholarly journals Comparison of Ketamine and Pentazocine with Fentanyl and Propofol combination for anaesthesia during laparoscopic tubal ligation

2019 ◽  
Vol 8 (4) ◽  
pp. 1525
Author(s):  
Ovais Nazir ◽  
Asif Hussain Bhat ◽  
Hamid Yatoo ◽  
Sanjeevni Gupta ◽  
Rajesh Misra
Keyword(s):  
Side Effects ◽  
Recovery Time ◽  
Postoperative Nausea And Vomiting ◽  
Rapid Onset ◽  
Tubal Ligation ◽  
Onset Of Action ◽  
Anaesthetic Agents ◽  
Minimally Invasive Surgical ◽  
Group I ◽  
Group Ii

Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique, without risk of major haemorrhage, early postoperative ambulation and alimentation, making it suitable for ambulatory surgery. The choice of aneasthesia for laparoscopic ligation hence should consider the anaesthetic agents with a rapid onset of action and fast recovery time, with minimal problems for intraoperative control of haemodynamic, airway and pain relief as well as take consideration of the safety, quality, efficacy, and utilization of resources available to the given situation.Methods: A total of 100 patients aged from 18 to 45 years who were scheduled to undergo laparoscopic tubal ligation  were divided into Group I-  Ketamine plus pentazocine group (n=50), Group II- Propofol plus fentanyl group (n=50) and studied  for the intraoperative parameters (hemodynamic and respiratory profile), recovery time, postoperative side effects and discharge time.Results: Intraoperatively MAP and HR were consistently higher in group I as compared to group II. Incidence of apnea and need for bag and mask ventilation was significantly more in Group II than in Group I as was the incidence of Bradycardia. Postoperative nausea and vomiting, psychomimetic effects were significantly more in Group I than in Group II. The time to reach modified PADSS ≥9 (discharge time) was significantly longer in group I (140.3±12.82 min than in group II 102.2±9.2 min), P<0.01.Conclusions: Combination of ketamine and pentazocine gives good anaesthetic conditions during procedure with less incidence of airway and haemodynamic complications intraoperatively but more incidence of postoperative side effects like nausea, vomiting, psycomimetic effects, and time to meet discharge criteria, compared to propofol plus fentanyl.

Apexification of Anterior Teeth

2012 ◽  
Vol 36 (3) ◽  
pp. 263-268 ◽  
Author(s):  
S Damle ◽  
H Bhattal ◽  
A Loomba
Keyword(s):  
Calcium Hydroxide ◽  
Treatment Time ◽  
P Value ◽  
Hydroxide Group ◽  
Anterior Teeth ◽  
Group I ◽  
Barrier Formation ◽  
Effective Option ◽  
Group Ii ◽  
Mean Time

Purpose: This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Tri-oxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors. Methods: Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups –Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months. Results: The mean time taken for barrier in Group I was 4.50 ± 1.56 months whereas for Group II was 7.93 ± 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 ± 1.49 months whereas the time period for Group II was 6.43 ± 2.59 months (p value- 0.0067). Conclusion: MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.

Continuous low-dose intravenous lidocaine is effective for visceral pain secondary to peritoneal carcinomatosis in terminal cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8533-8533
Author(s):  
T. Tanaka ◽  
S. Okano ◽  
R. Tsukui ◽  
M. Tomaru ◽  
M. Ueno ◽  
...  
Keyword(s):  
Side Effects ◽  
Peritoneal Carcinomatosis ◽  
Low Dose ◽  
Visceral Pain ◽  
Terminally Ill ◽  
Oral Intake ◽  
Intravenous Lidocaine ◽  
Terminally Ill Patients ◽  
Abdominal Symptoms ◽  
Lidocaine Administration

8533 Background: Lidocaine, a local anesthetic, is often used as an anti-arrhythmic and as an analgesic of best support care (BSC) for patients with neuropathic pain. However, little is known about the effect of low-dose lidocaine on the abdominal pain of terminally-ill patients with peritoneal carcinomatosis. Aim: To evaluate whether visceral pain is controlled and activities of daily life (ADL) are improved during continuous lidocaine infusion. Methods: 28 terminally ill patients with peritoneal carcinomatosis due to the gastrointestinal (26) and gynecologic (2) cancers were studied. Despite aggressive pain management with opiates, non-steroidal anti-inflammatory drugs and other adjuvants, debilitating pain persisted. After a test dose of 2mg/kg intravenously, lidocaine was administered at low-doses (0.4 and/or 0.8mg/kg-h) through a vein and continued for more than 24 hours. Pain was quantitated on a faces rating scale from the level 0 (no pain) to 5 (severe pain); doses of opiates, amounts of oral intake, side effects, and ADL were measured before and after lidocaine. Results: Age (mean±SE) was 62±2, and percentage of males was 54%. Patients were not hypercalcemia but were slightly malnutrished (albumin 2.9±0.1g/dl) and anemic (hemoglobin 10.3±0.4g/dl). The duration of lidocaine administration in hospital was 18±3days. Abdominal symptoms improved within 1.2±0.1days after beginning lidocaine, and pain scale decreased from 2.7±0.2 to 0.6±0.2; p<0.001. In 68% of patients, the pain level became zero. Blood concentration of lidocaine at 0.8mg/kg-h was 3.0±0.4μg/ml 1 week later. 68% of patients needed no increase in opiate dosage during lidocaine administration. Waist size did not decrease, however, oral intake increased (p=0.002) during lidocaine administration. No obvious side effects, such as perioral numbness, were seen except for emotional lability noted in 4 patients. 43% patients were able to be discharged for continued end-of-life comfort care with home parenteral nutrition and continuation of lidocaine administration. Conclusions: We suggest that continuous, low-dose intravenous lidocaine is BSC and is a very effective approach for analgesia and improvement of ADL in patients with peritoneal carcinomatosis. No significant financial relationships to disclose.

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