scholarly journals Epidural Ropivacaine and Dexmedetomidine with that of Epidural Ropivacaine and Fentanyl for Postoperative Analgesia in Lumbar Spine Surgeries- A Randomised Double-Blinded Study

2021 ◽  
Author(s):  
G Prashanth ◽  
Sulochana Dash ◽  
Sudeep Mohapatra ◽  
Nupur Moda
Keyword(s):  
Lumbar Spine ◽  
Postoperative Analgesia ◽  
Analgesic Efficacy ◽  
Sedation Score ◽  
Categorical Variables ◽  
P Value ◽  
Epidural Administration ◽  
Rescue Analgesia ◽  
Blinded Study ◽  
Double Blinded

Introduction: Epidural with opioids as adjuvants are the most common agents of choice for postoperative analgesia in spine surgeries which promote early ambulation, increased patient satisfaction and improved outcome. Recently, epidural administration of α2 agonists in combination with local anaesthetics in low doses offers new dimensions in the management of postoperative pain. Aim: To compare the analgesic efficacy, sedation score and haemodynamic stability of Epidural Ropivacaine and Fentanyl (RF) with that of Ropivacaine and Dexmedetomidine (RD) in the postoperative period in lumbar spine surgeries. Materials and Methods: This was a randomised, double-blinded study conducted on 120 patients at IMS and SUM Hospital, Bhubaneswar, Khordha, India. Haemodynamic parameters, Visual Analogue Score (VAS), sedation score, time to 1st dose of rescue analgesics requirement and complications were observed. The study consisted of group RF that received ropivacaine and fentanyl and group RD that received ropivacaine and dexmedetomidine, with 60 patients in each group. Continuous variables were analysed with the unpaired t-test and categorical variables were analysed with Chi-square Test and Fisher-Exact test. Statistical significance was taken as p <0.05 Results:ThemeanageofparticipantsingroupRDwas39.73±7.192 years and in group RF was 40.67±7.434 years (p-value 0.872). Heart rate was in lower range in RD group throughout the study and was statistically significant with a p-value <0.05. VAS score was lower, sedation score was higher and time to 1st dose of rescue analgesia were longer in RD group compared to group RF (p<0.005). Complications like hypotension (33.3%), bradycardia (20%) were more common in group RD while nausea, vomiting (16.67%) and pruritis (10%) were noted in group RF. Conclusion: Dexmedetomidine seems to be a better neuraxial adjuvant with good postoperative analgesic efficacy, better patient comfort and hemodynamic stability compared with that of fentanyl.

scholarly journals A Randomised, Double Blinded Study on Comparison of Intrathecal Morphine and Clonidine as Adjuvant for Post-caesarean Analgesia

2020 ◽  
Author(s):  
Susmita Ghosh ◽  
Sankar Roy ◽  
Bidyut Bikas Gharami ◽  
Arunava Biswas ◽  
Dipasri Bhattacharya ◽  
...  
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Postoperative Analgesia ◽  
P Value ◽  
Time Interval ◽  
Morphine Group ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Blinded Study ◽  
Double Blinded

Introduction: Caesarean section is a common obstetric operation which requires adequate and safe postoperative analgesia sometimes using morphine or clonidine to provide comfort to the mother and ease in handling the new born. Aim: To compare the adjuvant effect of morphine and clonidine when co-administered intrathecally with 0.5% bupivacaine heavy during caesarean section. Materials and Methods: A randomised double-blinded study was conducted on 90 parturient were randomly divided into three groups, during March to November 2011, receiving intrathecal 100 mcg morphine, 75 mcg clonidine and 0.5 mL normal saline along with 2.5 mL of 0.5% bupivacaine respectively. The quality and duration of postoperative analgesia and any side effects were assessed at fixed time interval. APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score of foetus was also done to assess their wellbeing. Statistical analysis was done using Analysis of Variance (for continuous variables like Blood Pressure, heart rate, etc.,) and chi-square test (for discrete variables like VAS score, side effects, etc.,). Results: Postoperative VAS score at different time were much lower in the morphine group as compared to clonidine group (p-value<0.001) at 2,8,24-hour interval postoperative period. The time required for 1st rescue analgesia was longer in morphine (14±7.33 hours) as compared to clonidine (7±1.02 hours) (p<0.001). The total dose of rescue analgesic required in 24 hours was less (p<0.001) in morphine (75±48.25 mg) group. Hypotension bradycardia and sedation (p-value 0.028) were more in clonidine group as compared to morphine group. Conclusion: Low dose morphine is better as an adjuvant than clonidine during spinal anaesthesia for relieving pain following caesarean section.

scholarly journals A comparative study of caudal anesthesia with bupivacaine v/s bupivacaine with dexmedetomidine in lower abdominal surgeries in pediatric age group

Pain medicine ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 25-29
Author(s):  
Kishore Kumar N. ◽  
Sandeep Kadam
Keyword(s):  
Adverse Effect ◽  
Postoperative Analgesia ◽  
Rescue Analgesia ◽  
Pediatric Age Group ◽  
Respiratory Parameters ◽  
Caudal Anaesthesia ◽  
Significant Difference ◽  
Blinded Study ◽  
Group B ◽  
Double Blinded

Background: caudal anaesthesia has short­term effect. Alpha­2 adenoreceptors when used as adjuvant to local anaesthetic in children prolongs analgesic duration. The study is aimed to assess the efficacy of addition of dexme­detomidine with Bupivacaine in caudal block for extending postoperative analgesia and its safety profile in pediatric infra­umbilical surgeries.Method: the prospective interventional longitudinal double blinded study was conducted on 60 patients randomly divided into two groups by simple lottery method: group B who received (0.25 %) bupivacaine 1 ml/kg plus 1 ml nor­mal saline (NS), and those in group BD who received (0.25 %) bupivacaine 1 ml/kg plus 0.5 μg/kg dexmedetomidine in 1 ml NS. Post­surgery, both groups were compared in R studio v1.2.5001. Association between the adverse effect and other variables (age, gender, type of surgery, groups) were assessed by Multiple linear regression.Results: in group BD, duration of analgesia prolonged significantly (P < 0.05). In group BD, FLACC score at initial four hours and at 12th hour was significantly less (P < 0.05). Group B was more likely to receive high number of rescue analgesia (P = 0.0005; OR = 11.769). No significant difference was observed concerning hemodynamics, respiratory parameters and adverse effect between both groups (P > 0.05). Conclusion: in children, dexmedetomidine when used along with bupivacaine prolongs postoperative analgesia du­ration, without any significant side effects.

scholarly journals A Randomized Double Blinded Study Comparing the Postoperative Analgesic Effects of Butorphanol, Parecoxib and Tramadol in Patients Undergoing Major Surgical Procedures

2019 ◽  
Vol 12 (2) ◽  
pp. 809-814
Author(s):  
Ranjan R. K, ◽  
Sunil B. V. ◽  
Neeta Santha
Keyword(s):  
Pain Intensity ◽  
Surgical Procedures ◽  
Sedation Score ◽  
Surgical Trauma ◽  
Pain Intensity Score ◽  
Rescue Analgesia ◽  
Analgesic Effects ◽  
Tissue Healing ◽  
Blinded Study ◽  
Double Blinded

Post-operative pain is an acute pain which starts with the surgical trauma and usually ends with tissue healing. Our study was done to evaluate and compare the postoperative analgesic effect of Butorphanol, Parecoxib and Tramadol in patients undergoing major surgical procedures. Randomized double blinded study. Sixty patients of ASA I and II grades of the age group 20­ to 50 years, undergoing major surgeries were included in the study. They were divided into three groups with 20 patients each. Group P­-Parecoxib, Group B­-Butorphanol group, and Group T –Tramadol group. Pain intensity score, pain relief score, sedation score, rescue analgesia and adverse events were noted. Hemodynamic parameters, respiratory rate and saturation were also recorded at regular intervals. The parameters observed were compared by ANOVA test. There was significant decrease in pain intensity scores from 10 minutes onwards which was observed in all the three groups but this decrease was more in Butorphanol group. In our study, higher sedation score was observed for Butorphanol group. Adverse effects like nausea, vomiting were more with tramadol group. Higher doses of rescue analgesia was required in Parecoxib group. Thus Butorphanol is a superior analgesic compared to tramadol and parecoxib, while side effects like nausea, vomiting was more in tramadol group.

scholarly journals Comparison of Caudal Tramadol with different doses of Midazolam addon for Postoperative analgesia in Children Undergoing Inguinoscrotal Operations

2019 ◽  
Vol 2 (1) ◽  
pp. 11-17
Author(s):  
Siddhartha Koirala ◽  
BK Bhattarai ◽  
TR Rahman ◽  
BP Sah
Keyword(s):  
Postoperative Analgesia ◽  
Pain Scale ◽  
Sedation Score ◽  
Epidural Administration ◽  
Maximum Volume ◽  
One Year ◽  
Double Blinded ◽  
To Receive ◽  
Effective Analgesia ◽  
Different Doses

Background: Safe and effective postoperative analgesic modalities have remained a subject of contemporary clinical research, particularly in children. The present study aimed at comparing the effectiveness of pain relief in children undergoing inguinoscrotal surgery with caudal tramadol alone and in combination with different doses of midazolam. Methods: Ninety children of either sex, aged one year to fifteen years, undergoing inguinoscrotalsurgical procedures under general anesthesia were recruited in a randomized double blinded fashion to receive one of the three study medications through caudal route. Group T (n= 30) received injectiontramadol 2mg/kg in a volume of 0.5ml/kg up to a maximum volume of 20ml, while group TM (n= 30)and TM/2 (n= 30) received additional midazolam 50mcg/kg and 25mcg/kg respectively. The study medications were administered immediately after induction of anesthesia. Postoperative analgesia was measured using a modified Hannallah 10 points Pediatric Objective Pain Scale described by Hannallah and colleagues. Pain score of ≤ 4 was considered effective analgesia. Duration of analgesia was defined as the time between caudal injection to the first need of analgesia. Results: The duration of analgesia in group TM (1145±281.41 min) and TM/2 (1012.67±260.68 min)was significantly longer than that in group T (690.83±215.7 min) (p<0.005). The sedation score was the highest in group TM and the least in group T. Nausea vomiting was the commonest side effect in all the three groups without any significant differences in the incidences between the groups. Conclusion: Addition of midazolam to tramadol for caudal administration in children undergoinginguinoscrotal operations produces significantly longer duration of postoperative analgesia than produced by epidural administration of tramadol alone.

scholarly journals Saddle Block for Transrectal Prostate Biopsy: A Comparison of the Analgesic Efficacy of 0.25% Bupivacaine and 0.375% Ropivacaine

2021 ◽  
Vol 7 (3) ◽  
pp. 292-301
Author(s):  
JO Bamigboye ◽  
SO Olateju ◽  
AF Faponle ◽  
AA Salako
Keyword(s):  
Prostate Biopsy ◽  
Statistical Significance ◽  
Analgesic Efficacy ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Pain Scores ◽  
Blinded Study ◽  
Transrectal Prostate Biopsy ◽  
Group B ◽  
Double Blinded

Background: Prostate biopsy is a painful procedure, and the degree of pain is related to the number of core biopsies taken. Objective: To compare the analgesic properties of hyperbaric bupivacaine 0.25% with 0.375% ropivacaine for saddle block in transrectal prostate biopsy. Methods: This was a randomised double-blinded study. Eighty patients with indications for prostate biopsy presenting at the Day-Case Theatre in a Nigerian tertiary facility were randomised into two equal groups: B (Bupivacaine) and R (Ropivacaine). Group B received 1ml of 0.25% bupivacaine, while Group R received 1ml of 0.375% ropivacaine for saddle block, respectively. Pain assessment, home readiness, patients' satisfaction, and time to first analgesic request were assessed and compared between the two groups. Results: The Bupivacaine group had an earlier onset of sensory block (11.90±4.10 minutes vs 23.70±8.65 minutes, p = 0.000), slower sensory block regression (48.73±9.32 minutes vs 24.88±4.21 minutes, p = 0.000), but delayed home readiness (47.23±15.93 minutes vs 29.88±8.58 minutes, p = 0.000), than patients in the Ropivacaine group. The pain scores during, immediately after and 30 minutes post-biopsy were lower in the Bupivacaine group: p = 0.010, p = 0.028 and p = 0.023 respectively. The time to first analgesic request was also longer in the Bupivacaine group (48.73±9.33 minutes) than for those in the Ropivacaine group (24.88±4.21 minutes) with statistical significance (p = 0.000). Conclusion: Intraoperative analgesic properties were better in the Bupivacaine group than in the Ropivacaine group. However, home readiness was earlier in the Ropivacaine group.

scholarly journals Analgesic Efficacy of Paracetamol in Children Using Tonsillectomy as a Pain Model

1996 ◽  
Vol 24 (6) ◽  
pp. 669-673 ◽  
Author(s):  
B. Anderson ◽  
S. Kanagasundarum ◽  
G. Woollard
Keyword(s):  
Pain Score ◽  
Venous Blood ◽  
Analgesic Efficacy ◽  
Temperature Plasma ◽  
Paracetamol Concentration ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
Induction Of Anaesthesia

The analgesic efficacy of paracetamol was assessed in a prospective, randomized, double-blinded study of 100 children undergoing tonsillectomy with or without adenoidectomy. Fifty children were given paracetamol elixir 40 mg/kg 40 minutes preoperatively (Group A); the remaining 50 children were given an oral placebo 40 minutes pre-operatively and paracetamol suppositories 40 mg/kg after induction of anaesthesia (Group B). Paracetamol was the only analgesic given and was given either orally or rectally in order to produce high variations in plasma paracetamol concentrations postoperatively. At 30 minutes after the end of surgery a pain score (0–10) was obtained and a venous blood sample was taken for serum paracetamol concentration analysis. Children given paracetamol elixir had a higher mean paracetamol concentration (0.15 [SD 0.06] mmol/l vs 0.05 [SD 0.03] mmol/l, P < 0.001) and a lower median pain score (5 vs 7, P < 0.02) than those who were given suppositories. The use of rescue morphine was higher (10 vs 23, P < 0.001) in the latter group. The incidence of nausea and vomiting was the same in both groups (20%) during the 24 hour postoperative period. Plasma paracetamol concentrations of 0.066–0.132 mmol/l are known to reduce temperature; plasma paracetamol concentrations which provide analgesia are unknown. Children with plasma paracetamol concentrations above 0.07 mmol/l had superior analgesia to those with concentrations below this level (P < 0.05).

Analgesic efficacy of intraperitoneal administration of bupivacaine in cats

2016 ◽  
Vol 18 (11) ◽  
pp. 906-912 ◽  
Author(s):  
Javier Benito ◽  
Beatriz Monteiro ◽  
Anne-Marie Lavoie ◽  
Guy Beauchamp ◽  
B Duncan X Lascelles ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Linear Models ◽  
Intraperitoneal Administration ◽  
Analgesic Efficacy ◽  
Pain Scale ◽  
Positive Control ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Blinded Study ◽  
Effect Of Treatment

Objectives The aim of this study was to evaluate the analgesic efficacy of intraperitoneal (IP) bupivacaine in cats undergoing ovariohysterectomy (OVH). Methods Forty-five cats were included in a randomized, prospective, blinded study after owners’ written consent was obtained. The anesthetic protocol included acepromazine–buprenorphine–propofol–isoflurane. A ventral midline incision was made and cats (n = 15/group) were administered either IP saline 0.9% (negative and positive control groups; NG and PG, respectively) or IP bupivacaine (2 mg/kg; bupivacaine group; BG). Cats in the PG received meloxicam (0.2 mg/kg SC). An OVH was performed and postoperative pain was evaluated using a dynamic interactive visual analog scale (DIVAS), the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT) for up to 8 h after the end of surgery. Postoperative sedation was evaluated using DIVAS. Rescue analgesia was provided with buprenorphine and/or meloxicam. Repeated measures linear models and a Cochran–Mantel–Haenszel test were used for statistical analysis ( P <0.05). Results There was a significant effect of treatment on the number of times rescue analgesia was administered ( P = 0.002) (PG, n = 2, 13%; NG, n = 12, 80%; BG, n = 4, 27%) with the number of rescues being higher in the NG group than in the PG ( P = 0.0004) and BG ( P = 0.02) groups. The DIVAS, MCPS and MNT were significantly different when compared with baseline values at different time points; however, data were not significantly different among groups. Conclusions and relevance Treatments PG and BG produced similar analgesia in terms of pain scores, number of times rescue analgesia was administered and MNT. Based on rescue analgesia, IP administration of bupivacaine provides analgesia in cats after OVH.

Tramadol vs nalbuphine: analgesic efficacy and side effects. A prospective, randomized, double-blinded study in children.

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 138-139 ◽  
Author(s):  
J. Ouaki ◽  
A. Rochette ◽  
O. Raux ◽  
Ch. Dadure ◽  
X. Capdevila
Keyword(s):  
Side Effects ◽  
Analgesic Efficacy ◽  
Blinded Study ◽  
Double Blinded
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