The Impact of Intraperitoneal Dexmedetomidine with Bupivacaine on Patients’ Postoperative Pain in Endometriosis Laparoscopic Surgery; A Randomized, Clinical Trial

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (p = 0.001) was found. Additionally, the interaction between time and different local analgesics (p < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (p < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine – n = 4, 20%; 0.5% levobupivacaine – n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (p < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine.

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Effect of Silymarin in the Treatment of Allergic Rhinitis

Otolaryngology ◽

10.1177/0194599811423504 ◽

2011 ◽

Vol 145 (6) ◽

pp. 904-909 ◽

Cited By ~ 10

Author(s):

Mehdi Bakhshaee ◽

Farahzad Jabbari ◽

Saeed Hoseini ◽

Reza Farid ◽

Mohammad Hadi Sadeghian ◽

...

Keyword(s):

Clinical Trial ◽

Allergic Rhinitis ◽

Randomized Clinical Trial ◽

Signs And Symptoms ◽

Study Group ◽

Positive Skin Prick Test ◽

Serum Ige ◽

Oxidative Stresses ◽

The Impact

Objective. Although the role of oxidative stresses has been confirmed in the pathophysiology of allergic rhinitis and the protective effect of silymarin against oxidative stresses has been proven in different organs, no study has yet been conducted on the impact of silymarin on allergic rhinitis treatment. Study Design. A randomized clinical trial study. Setting. Two tertiary referral centers with otorhinolaryngology–head and neck surgery and allergy and immunology departments. Patients and Methods. In a randomized clinical trial, 94 patients with the signs and symptoms of allergic rhinitis and a positive skin prick test were selected and randomly divided into 2 groups. Their signs and symptoms, eosinophil percentage on nasal smear, serum IgE, and interleukin (IL-4, IL-5, interferon-γ) levels were recorded. The study group was treated with silymarin, whereas the control group received placebo, both for 1 month, along with routine antihistamine treatment. At the end of the treatment course, clinical and laboratory findings were statistically analyzed. Results. Sixty patients completed the trial. Based on the Sino-Nasal Outcome Test 20 (SNOT-20), a significant improvement in clinical symptom severity was observed in both groups (9.23 ± 5.14 vs 2.20 ± 2.69; P < .001), which was statistically significantly higher in the study group ( P < .001). Posttreatment percentage of nasal eosinophils and cytokine levels showed no significant difference ( P > .05). Rise in serum IgE level was seen after treatment with silymarin ( P = .003). Conclusion. Considering the statistically effective role of silymarin in alleviating the severity of allergic rhinitis symptoms, applying this herbal antioxidant along with other medications may result in better management.

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The Impact of Continuous Glucose Monitoring on Markers of Quality of Life in Adults With Type 1 Diabetes: Further Findings From the DIAMOND Randomized Clinical Trial

Diabetes Care ◽

10.2337/dc17-0133 ◽

2017 ◽

Vol 40 (6) ◽

pp. 736-741 ◽

Cited By ~ 89

Author(s):

William H. Polonsky ◽

Danielle Hessler ◽

Katrina J. Ruedy ◽

Roy W. Beck

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Type 1 Diabetes ◽

Randomized Clinical Trial ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

The Impact

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Faculty Opinions recommendation of Effects of Mediterranean Diet or Mindfulness-Based Stress Reduction on Prevention of Small-for-Gestational Age Birth Weights in Newborns Born to At-Risk Pregnant Individuals: The IMPACT BCN Randomized Clinical Trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.741287861.793590912 ◽

2022 ◽

Author(s):

Dave Bridges

Keyword(s):

Clinical Trial ◽

At Risk ◽

Randomized Clinical Trial ◽

Mediterranean Diet ◽

Stress Reduction ◽

Gestational Age ◽

Small For Gestational Age ◽

Mindfulness Based Stress Reduction ◽

The Impact

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Impact of the Timing of Rocuronium Injection after Propofol Administration on Temporal Summation of Pain in Gynecologic Laparoscopic Surgery: A Prospective and Controlled Study

Pain Research and Management ◽

10.1155/2020/6642460 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Jaehak Jung ◽

Byoungryun Kim ◽

Seong Nam Park ◽

Jiheui Lee ◽

Insung Choi ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Postoperative Pain ◽

Temporal Summation ◽

Opioid Consumption ◽

Controlled Study ◽

Injection Pain ◽

Pain Patient ◽

Patient Controlled Analgesia ◽

Pain Outcomes ◽

The Impact

Purpose. Temporal summation of pain, which is defined as the perception of greater pain evoked by repetitive painful stimuli, varies among individuals. This study aimed at determining the impact of the timing of rocuronium after induction with propofol on the temporal summation of pain. Methods. One hundred patients aged 19–60 years underwent gynecologic laparoscopic surgery. Patients were randomly assigned to one of the two groups: group PRi received immediate injections of rocuronium after propofol administration and group PRd received rocuronium injections when the bispectral index score (BIS) decreased to <60 after propofol administration. The grade of rocuronium-induced withdrawal movement (RIWM) according to the timing of propofol injection, the incidence and severity of propofol injection pain (PIP), rescue analgesics, visual analog scale (VAS) score after surgery for postoperative pain, patient-controlled analgesia (PCA) opioid consumption, association between PIP and the grade of RIWM, and associations between PIP, the grade of RIWM, and postoperative pain outcomes were measured. Results. The differences between the incidence and severity of PIP in the two groups were not significant. The grade of the RIWM in the PRd group was significantly reduced compared with the PRi group. Rescue analgesics, severity for postoperative pain, and PCA opioid consumption were not significant. Correlations between the incidence and severity of PIP and the grade of RIWM were weakly negative. Correlations between the grade of RIWM and pain outcomes were moderately positive, but correlations between the severity for PIP and the postoperative pain outcomes were negligible. Conclusion. The timing of rocuronium administration after propofol injection played a role in reducing RIWM. The grade of RIWM was significantly related to pain outcomes compared with the severity of PIP. Therefore, delayed rocuronium injection after induction with propofol reduced temporal summation of pain.

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