scholarly journals Efficacy of Intraperitoneal Dexamethasone Infusion in Reduction of Shoulder Pain and Nausea/Vomiting After Gynecological Laparoscopy

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Behnaz Nouri ◽  
Maliheh Arab ◽  
Somaye Lotfpour
Keyword(s):  
Shoulder Pain ◽  
Intervention Group ◽  
Treatment Strategies ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Opioid Use ◽  
Double Blind ◽  
Mean Values ◽  
Gynecological Laparoscopy ◽  
Surgery Duration

Background: The reduction of shoulder pain and postoperative nausea and vomiting (PONV), causing great discomfort for patients after gynecological laparoscopy, requires preventive or treatment strategies. Objectives: The present study aimed to determine the efficacy of intraperitoneal (IP) dexamethasone in the reduction of shoulder pain and PONV after gynecological laparoscopy. Methods: In this double-blind, randomized clinical trial, 130 consecutive patients undergoing gynecological laparoscopy were randomly assigned to two groups of 65 patients within May 2015 to May 2016. One group received 16 mg IP dexamethasone before the end of the surgery, and the other group received the placebo (i.e., the IP infusion of distilled water). Patients' age and body mass index (BMI), and surgery duration were recorded in this study. The severity of shoulder pain was evaluated by the visual analog scale (VAS) at recovery and 2, 6, 12, and 24 h after the surgery. Moreover, the need for opioid use and PONV were recorded within the first 24 h after the surgery. The study outcomes were compared between the two study groups and among the different intervals using SPSS software (version 21). Results: The groups had similar demographics (i.e., age and BMI) and mean surgery duration (P > 0.05). The mean values of VAS scores of the intervention group were lower than those of the placebo group at five intervals (P = 0.001). The frequency of opioid use was significantly lower in the dexamethasone group (P = 0.010). In addition, 20% and 60% of the patients in the dexamethasone and placebo groups had PONV, respectively (P < 0.001). Conclusions: The IP dexamethasone is effective in the reduction of shoulder pain and nausea/vomiting after gynecological laparoscopy and can significantly reduce opioid requirement within the first 24 h after surgery; however, IP dexamethasone does not increase surgery duration. Therefore, it is recommended to use this technique during gynecological laparoscopy.

scholarly journals A Combination of Lactoplantibacillus plantarum Strains CECT7527, CECT7528 and CECT7529 Plus Monacolin K Reduces Blood Cholesterol: Results from a Randomized, Double-Blind, Placebo-Controlled Study

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1206
Author(s):  
Rafael Guerrero-Bonmatty ◽  
Guadalupe Gil-Fernández ◽  
Francisco José Rodríguez-Velasco ◽  
Jordi Espadaler-Mazo
Keyword(s):  
Intervention Group ◽  
Study Groups ◽  
Statin Treatment ◽  
Blood Cholesterol ◽  
Controlled Study ◽  
Controlled Clinical Trial ◽  
Red Yeast Rice ◽  
Monacolin K ◽  
Double Blind ◽  
History Of

Background: Dietary supplements have been proposed to help manage blood cholesterol, including red yeast rice (RYR) extracts, plant sterols and stanols, beta-glucans, and some probiotics. This study was conducted to evaluate the efficacy of RYR (containing 10 mg of monacolin K) combined with 109 CFU of three Lactoplantibacillus plantarum strains (CECT7527, CECT7528, and CECT7529). Methods: A 12-week randomized, double-blinded, placebo-controlled clinical trial was conducted. In total, 39 adult patients were enrolled, having total cholesterol (TC) ≥200 mg/dL, and being statin-naïve or having recently stopped statin treatment because of intolerance. Active product or placebo were taken once daily, and subjects were evaluated at baseline, 6, and 12 weeks. Results: Study groups were comparable at baseline, except for history of recent hypercholesterolemia treatment (81% in active vs. 22% in placebo). Changes in LDL cholesterol and TC became significant compared to placebo (mean difference between groups and standard error of the mean = 23.6 ± 1.5 mg/dL, p = 0.023 and 31.4 ± 1.9 mg/dL, p = 0.011, respectively) upon adjusting for the baseline imbalance in hypercholesterolemia treatment. No adverse effects were noted during the study. Conclusion: This combination of 10 mg of monacolin K and L. plantarum strains was well tolerated and achieved a statistically significant greater reduction in LDL-C and TC in the intervention group compared to the placebo, once adjusting for recent history of hypercholesterolemia treatment.

scholarly journals Evaluating the Effect of Intraoperative Dextrose 10% Administration on Reducing Postoperative Nausea and Vomiting after Laparoscopic Surgery

2019 ◽  
Vol 13 (1) ◽  
pp. 78-85
Author(s):  
Ashraf Nabil Saleh ◽  
Dalia Fahmy Emam ◽  
Mohamed Mohamed Kamal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Primary Objective ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Double Blind ◽  
Female Patients ◽  
Medication Consumption

Background: Although PONV is usually self-limiting or is treated without sequelae, the incidence of PONV could be as high as 70% to 80% in high-risk populations such as female sex, obese patients, age younger than 40 years, nonsmoker patients, history of PONV or motion sickness. Objectives: The study aimed to investigate whether dextrose 10% decreases the incidence of postoperative nausea and vomiting in female patients undergoing laparoscopic cholecystectomy Materials and Methods: This prospective, double-blind randomized placebo-controlled study comprised 130 ASA physical status I and II nonsmoker female patients, 20-40 years of age, scheduled for laparoscopic cholecystectomy at Ain Sham University – Assembled operating theater from August 2018 to October 2018. Patients were arbitrarily divided into two study groups of 65 patients each. Group LR received lactated Ringer’s solution and group D received 10% dextrose. The primary objective of this study was to compare the incidence of PONV in the study treatment groups. The secondary outcomes included measurement of antiemetic medication consumption as well as blood glucose changes between groups. Results: 50 from a total of 65 participants (76.9%) in Lactated Ringer (LR) group experienced nausea. On the other hand, 30 participants only (46.2%) in dextrose (D) group were nauseated. This dissimilarity was statistically highly significant (P= 0.0003). Conclusion: In this study, dextrose 10% administration resulted in improved postoperative emesis management as explained by the lower incidence of nausea and rescue antiemetic consumption.

Urine and Plasma Catecholamine and Cortisol Concentrations after Myocardial Revascularization 

1997 ◽  
Vol 86 (4) ◽  
pp. 785-796 ◽  
Author(s):  
J. Jerill Plunkett ◽  
John D. Reeves ◽  
Long Ngo ◽  
Wayne Bellows ◽  
Steven L. Shafer ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Repeated Measures ◽  
Bypass Graft ◽  
Myocardial Revascularization ◽  
Study Groups ◽  
Plasma Catecholamine ◽  
Bolus Administration ◽  
Opioid Use ◽  
Double Blind ◽  
Urine Cortisol

Background Cardiopulmonary bypass is associated with substantial release of catecholamines and cortisol for 12 or more h. A technique was assessed that may mitigate the responses with continuous 12-h postoperative sedation using propofol. Methods One hundred twenty-one patients having primary elective cardiopulmonary bypass graft (CABG) surgery were enrolled in a double-blind, randomized trial and anesthetized using a standardized sufentanil-midazolam regimen. When arriving at the intensive care unit (ICU), patients were randomly assigned to either group SC (standard care), in which intermittent bolus administration of midazolam and morphine were given as required to keep patients comfortable; or group CP (continuous propofol), in which 12 h of continuous postoperative infusion of propofol was titrated to keep patients deeply sedated. Serial perioperative measurements of plasma and urine cortisol, epinephrine, norepinephrine, and dopamine were obtained; heart rate and blood pressure were recorded continuously, and medication use, including requirements for opioids and vasoactive drugs, was recorded. Repeated-measures analysis was used to assess differences between study groups for plasma catecholamine and cortisol levels at each measurement time. Results In the control state-before the initiation of postoperative sedation in the ICU-no significant differences between study groups were observed for urine or plasma catecholamine or cortisol concentrations. During the ICU study period, for the first 6-8 h, significant differences were found between study groups SC and CP in plasma cortisol (SC = 28 +/- 15 mg/dl; CP = 19 +/- 12 mg/dl; estimated mean difference [EMD] = 9 mg/dl; P = 0.0004), plasma epinephrine (SC = 132 +/- 120 micrograms/ml; CP = 77 +/- 122 micrograms/ml; EMD = 69 micrograms/ml; P = 0.009), urine cortisol (SC = 216 +/- 313 micrograms/ml; CP = 93 +/- 129 micrograms/ml; EMD = 127 micrograms/ml; P = 0.007), urine dopamine (SC = 85 +/- 48 micrograms; CP = 52 +/- 43 micrograms; EMD = 32 micrograms; P = 0.002), urine epinephrine (SC = 7 +/- 8 micrograms; CP = 4 +/- 5 micrograms; EMD = 3 micrograms; P = 0.0009), and urine norepinephrine (SC = 24 +/- 14 mg; CP = 13 +/- 9 mg; EMD = 11 mg; P = 0.0004). Reductions in urine and plasma catecholamine and cortisol concentrations found for the CP group generally persisted during the 12-h propofol infusion period and then rapidly returned toward control (SC group) values after propofol was discontinued. Postoperative opioid use was reduced in the CP group (SC = 97%; CP = 49%; P = 0.001), as was the incidence of tachycardia (SC = 79%; CP = 60%; P = 0.04) and hypertension (SC = 58%; CP = 33%; P = 0.01), but the incidence of hypotension was increased (SC = 49%; CP = 81%; P = 0.001). Conclusions Cardiopulmonary bypass graft surgery is associated with substantial increases in plasma and urine catecholamine and cortisol concentrations, which persist for 12 or more h. This hormonal response may be mitigated by a technique of intensive continuous 12-h postoperative sedation with propofol, which is associated with a decrease in tachycardia and hypertension and an increase in hypotension.

scholarly journals Efficacy of Hawthorn fruit extract on blood pressure and quality of sleep in patients with hypertension along with sleep disorders: A randomized double-blind controlled trial

2021 ◽  
Vol 7 (4) ◽  
Keyword(s):  
Blood Pressure ◽  
Sleep Disorder ◽  
Controlled Trial ◽  
Intervention Group ◽  
Study Groups ◽  
Quality Of Sleep ◽  
Fruit Extract ◽  
Double Blind ◽  
Significant Difference

Objective: This study aimed to investigate the effect of Crataegus monogyna (C.monogyna) on controlling the blood pressure in patients with hypertension along with sleep disorder. Methods: This was a parallel double-blind, placebo-controlled trial study from May, 2018 to December, 2019. Total of 60 patients with hypertension and sleep disorder were randomly assigned to C.monogyna and placebo groups. The groups received C.monogyna and placebo capsules twice-daily for 8 weeks. The primary outcomes were the changes of systolic and diastolic blood pressure and Pittsburgh questionnaire’s scores from baseline measurements. The secondary outcomes were changes in serum biochemical markers from baseline. Results: Before treatment, there was no significant difference between study groups in terms of demographic data and outcomes (P>0.05) except body mass index (P=0.02). After treatments, the intervention group had a significant improvement in systolic and diastolic blood pressure compared to placebo ((118.14±6.76 vs 129.76±8.28, 95% CI: 7.54 – 15.69, P<0.001 and 77.14±5.32 vs 83.57±6.73, 95% CI: 3.17 – 9.68, P<0.001, respectively) analysis revealed no significant difference observed between study groups in terms of baseline characteristics and pre-and posttreatment laboratory tests. Also, none of the groups had superiority in terms of the Pittsburgh questionnaire’s scores (P=0.44); however, the intragroup analysis revealed significant improvements in the intervention group (P= 0.001). Conclusion: C.monogyna fruit extract as a supplementary medication has beneficial effects on controlling blood pressure and quality of sleep in patients with hypertension along with sleep disorders.

scholarly journals Topical use of Matricaria recutita L (Chamomile) Oil in the Treatment of Monosymptomatic Enuresis in Children

2016 ◽  
Vol 22 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Hosein Sharifi ◽  
Mohammad Bagher Minaie ◽  
Mohammad Javad Qasemzadeh ◽  
Nematollah Ataei ◽  
Mohammad Gharehbeglou ◽  
...  
Keyword(s):  
Adverse Event ◽  
Controlled Trial ◽  
Intervention Group ◽  
Study Groups ◽  
Double Blind ◽  
Mean Frequency ◽  
Parallel Design ◽  
Matricaria Recutita ◽  
The Mean ◽  
To Receive

Aim. To evaluate the efficacy of topical use of Matricaria recutita L oil in the treatment of enuresis in children. Methods. Eighty patients diagnosed as monosymptomatic nocturnal or daytime enuresis were allocated to receive Matricaria recutita L (chamomile) oil or placebo topically for 6 weeks in a double-blind randomized placebo-controlled trial with a parallel design. Patients were evaluated prior to and following 8 weeks of the intervention in terms of frequency of enuresis and any observed adverse events. Results. The mean frequency of enuresis at the first, second, and third 2 weeks was lower in the intervention group compared with the placebo group, and the differences were statistically significant ( P < .001, P = .03, and P < .001, respectively). There was no report of any adverse event in the study groups. Conclusion. The findings of this study showed that the topical use of (chamomile) oil can decrease the frequency of nocturia in children with monosymptomatic nocturnal or daytime enuresis.

scholarly journals Comparison of Ondansetron and Granisetron Effects for Prevention of Nausea and Vomiting Following Strabismus Surgery

2019 ◽  
Vol 7 (19) ◽  
pp. 3195-3200
Author(s):  
Shirin Salajagheh ◽  
Soodeh Kuhestani ◽  
Mahdieh Sharifzadeh Kermani ◽  
Omid Taheri ◽  
Naeimeh Naeimi Bafghi
Keyword(s):  
Postoperative Nausea ◽  
Rating Scale ◽  
Intervention Group ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Chi Square ◽  
Double Blind ◽  
Significant Difference

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common complaint after strabismus surgery that leads to unpleasantness, increased hospitalisation time and increased costs. In severe cases, it can lead to dehydration, electrolyte disturbances, aspiration, pneumonia, and even sutures opening. AIM: This study was conducted to compare the effects of both ondansetron and granisetron on the reduction of PONV after strabismus surgery. METHODS: This randomised, and the double-blind clinical study was conducted on patients with ASA I and II undergoing strabismus surgery with age over 3 years old in Shafa Hospital, Kerman University of Medical Sciences during 2017 under general anaesthesia. Patients with inclusion criteria were randomly assigned to one of three groups including Ondansetron (A), Granisetron (B) and control group (C). Matching cases and controls on drugs were fully completed. Furthermore, 100 μg/kg of Ondansetron was intravenously injected, followed by injection of 40 μg/kg Granisetron for another intervention group. All patients underwent the same anaesthetic procedure and intravenous injection of drugs during anaesthesia induction. The severity of nausea and vomiting in recovery, 6 and 18 hours after the operation were verified according to the Verbal Rating Scale (VRS). Our data were analysed by Chi-square, ANOVA and TUKEY tests via SPSS version 18. RESULTS: There was no significant difference between the three groups in terms of age and sex. The incidence of postoperative nausea in recovery among three groups of A, B and C was determined to be 15, 7.5 and 37.5%, respectively. No significant difference was found between the two groups A and B (P = 0.68), although there was a significant difference between these two groups and group C (P < 0.05). The incidence of nausea at 6 hours after surgery in groups A, B and C was recorded as 40, 15 and 65% respectively, indicating that the incidence of nausea in group B was significantly lower than the other two groups, while showed a significant difference with group A (P = 0.039) and group C (P < 0.05). Also, the incident of nausea between groups was not statistically significant 18 hours after surgery (P < 0.05). Additionally, no significant difference was found in different groups in terms of vomiting incidence in recovery, 6 and 18 hours after surgery (P < 0.05). CONCLUSION: Our study suggests that Granisetron is more effective in preventing PONV during 6 hours after the surgery in comparison with Ondansetron which makes it a favourable alternative for preventing PONV.

scholarly journals Clinical Efficacy of a Spray Containing Hyaluronic Acid and Dexpanthenol after Surgery in the Nasal Cavity (Septoplasty, Simple Ethmoid Sinus Surgery, and Turbinate Surgery)

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Ina Gouteva ◽  
Kija Shah-Hosseini ◽  
Peter Meiser
Keyword(s):  
Hyaluronic Acid ◽  
Observational Study ◽  
Nasal Cavity ◽  
Intervention Group ◽  
Sinus Surgery ◽  
Control Group ◽  
Nasal Breathing ◽  
Double Blind ◽  
Mucosal Regeneration ◽  
Mean Values

Background. This prospective, controlled, parallel-group observational study investigated the efficacy of a spray containing hyaluronic acid and dexpanthenol to optimise regular treatment after nasal cavity surgery in 49 patients with chronic rhinosinusitis. Methods. The control group received standard therapy. Mucosal regeneration was determined using rhinoscopy sum score (RSS). Pre- and postoperative nasal patency was tested using anterior rhinomanometry. The participants were questioned about their symptoms. Results. Regarding all RSS parameters (dryness, dried nasal mucus, fibrin deposition, and obstruction), mucosal regeneration achieved good final results in both groups, tending to a better improvement through the spray application, without statistically significant differences during the whole assessment period, the mean values being 7.04, 5.00, 3.66, and 3.00 (intervention group) and 7.09, 5.14, 4.36, and 3.33 (control group). No statistically significant benefit was identified for nasal breathing, foreign body sensation, and average rhinomanometric volume flow, which improved by 12.31% (control group) and 11.24% (nasal spray group). Conclusion. The investigational product may have additional benefit on postoperative mucosal regeneration compared to standard cleaning procedures alone. However, no statistically significant advantage could be observed in this observational study. Double-blind, controlled studies with larger populations will be necessary to evaluate the efficacy of this treatment modality.

Antipsychotics in obsessive-compulsive disorder - an auspicious approach for treatment-resistant patients?

2011 ◽  
Vol 26 (S2) ◽  
pp. 1236-1236
Author(s):  
M. Dold ◽  
M. Aigner ◽  
R. Lanzenberger ◽  
S. Kasper
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Intervention Group ◽  
Study Groups ◽  
Control Group ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
First Choice

IntroductionBecause only 40 – 60% of all patients with obsessive-compulsive disorder (OCD) respond to selective serotonin reuptake inhibitors (SSRIs), the evaluation of alternative therapy methods in the presence of treatment resistance has high clinical relevance. In this context, many studies have examined additive medication with antipsychotics.MethodAll double-blind randomised controlled trials (DBRCTs) that evaluated the efficacy of a combination therapy of antipsychotics and SSRIs in treatment-resistant OCD were covered by systematic literature searches.ResultsA total of ten DBRCTs were identified (four for quetiapine, three for risperidone, two for olanzapine and one for haloperidol) with a participant collective comprising in total 316 treatment-resistant OCD patients. After the augmentation therapy, significantly more subjects in the intervention group (antipsychotic + SSRI), 32% of the patients, fulfilled the response criterion (reduction in the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) ≥ 35%) than in the control group (placebo + SSRI) (relative risk (RR) = 2.08; 95% CI: 1.3 – 3.32). The standardised mean difference (SMD) of the Y-BOCS reduction between the pooled two study-groups revealed an effect size of 0,62. The sub-group analyses showed significant efficacy only for haloperidol and risperidone. Further significant differences existed regarding the duration of SSRI medication before the augmentation phase.Conclusion / DiscussionBased on the favourable benefit-risk-ratio, risperidone can be regarded as the agent of first choice for augmentation treatment with an SSRI. Overall, about one third of patients benefit from this therapy option. However, further scientific studies are needed before sufficiently empirically secured pharmacological treatment recommendations can be expressed.

Could Anise decrease the intensity of premenstrual syndrome symptoms in comparison to placebo? A double-blind randomized clinical trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Maryam Farahmand ◽  
Davood Khalili ◽  
Fahimeh Ramezani Tehrani ◽  
Gholamreza Amin ◽  
Reza Negarandeh
Keyword(s):  
College Students ◽  
Clinical Trial ◽  
Premenstrual Syndrome ◽  
Intervention Group ◽  
Study Groups ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Double Blind ◽  
High Prevalence

AbstractBackgroundPremenstrual syndrome (PMS) has a high prevalence among women of reproductive ages but despite its high prevalence, it has no determined and absolute treatment, so far. So, the aim of the present study was to compare the effect Pimpinella Anisum (Anise) with placebo on the intensity of the symptoms of PMS.MethodsThe present study was a randomized double-blind controlled clinical trial. College students who were suffering from PMS and had the inclusion criteria were selected and randomly assigned into two groups of intervention (Anise) and control (placebo). Participants in the intervention group, received 110 mg capsules of Anise three times day (a total dose of 330 mg per day); the control group received similar capsules with the same dosing that contained starch. Consumption of the capsules was started 7 days before the start of the menstruation and continued until 3 days after, which was a total of 10 days during two consecutive menstruation cycles. The intensity of the symptoms of premenstrual syndrome was measured using Premenstrual Symptoms Screening Tool (PSST). To compare the intensity of the symptoms between the two study groups, generalized estimating equation statistical method was used.ResultsEventually, sixty-seven 18–35 year old college students who were suffering from premenstrual syndrome were enrolled in the study. Comparing the mean score of the intensity of the syndrome between the two groups after the first and the second menstruation cycles showed a decrease in the intervention group to 13.9 (p-value<0.001; 95% CI: 16.5,−11.4) and 9.8 (p-value<0.001; 95% CI: 12.4,−7.3), respectively.ConclusionResults of the study showed that, in general, Anise was effective in decreasing the symptoms of premenstrual syndrome in comparison to placebo.

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