scholarly journals Evaluation of the Effect of Tenoxicam Compared to Diclofenac Sodium in Controlling Postoperative Pain in Third Molar Surgery

2021 ◽  
pp. 237-243
Author(s):  
Ramvihari Thota ◽  
Senthilnathan Periasamy ◽  
N. Mahathi
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Diclofenac Sodium ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Surgical Trauma ◽  
Treatment Groups ◽  
Average Pain ◽  
Group A ◽  
Group B

Aim: The aim of this study is to evaluate the effect of tenoxicam compared to diclofenac sodium in controlling postoperative pain after third molar surgery. Materials and Methods: 36 patients with mean age 30 were selected randomly and placed them in two groups A and B, under group A there are 18 patients and in group B 18 patients were placed, group a is given with tenoxicam 30 mg and for  group b diclofenac sodium 50 mg. Results: Group A experienced significantly less pain than those patients in group b. at 24 hr on the day of surgery, average pain scores of patients in both treatment groups did not differ significantly. On the evening of the third day postoperatively, the group a (tenoxicam) patients experienced significantly less pain than those in group b (diclofenac sodium). Discussion: It is generally accepted that pain following third molar surgery reaches moderate to severe intensity within the first 5 hr after surgery. Pain control in this period is thus of vital importance to the oral surgeon. NSAIDs have shown considerable analgesic activity for the relief of pain after surgery. Prostaglandin concentrations do not peak until 4 hr after surgical trauma. tenoxicam has been shown in our study to produce significant analgesia when compared to diclofenac sodium, especially at 3 to 4 hr postoperatively, the period when there is maximum prostaglandin formation in the tissue. Conclusion: Tenoxicam as administered in the present study was significantly more efficacious than diclofenac sodium and useful for pain control in these cases.

scholarly journals Dexmedetomidine and Fentanyl for Postoperative Analgesia in Patients Undergoing Abdominal Surgery: Randomised Controlled Trial

2021 ◽  
Author(s):  
Prashant Sachan ◽  
Prem Raj Singh ◽  
Sateesh Verma ◽  
Brij Bihari Kushwaha
Keyword(s):  
Postoperative Pain ◽  
Randomised Controlled Trial ◽  
Abdominal Surgery ◽  
Postoperative Analgesia ◽  
Pain Control ◽  
Controlled Trial ◽  
Haemodynamic Stability ◽  
Group A ◽  
Group B ◽  
Randomised Controlled

Introduction: Pain control is an important factor for postoperative recovery. Many drugs have been studied for effectiveness of postoperative analgesia. Fentanyl is a conventional drug and dexmedetomidine is one of the emerging drugs used for analgesia and postoperative pain control. Aim: To compare the effect of fentanyl and dexmedetomidine on pain control and haemodynamic stability. Materials and Methods: A randomised controlled trial was conducted on 60 patients (30 each group) undergoing for abdominal surgery, between January 2019 to January 2020. Group A received fentanyl loading dose 2 μg/kg I.V. followed by 0.5 μg/kg/hr infusion and group B received dexmedetomidine loading 1 μg/kg over 10 minutes followed by maintenance 0.5 μg/kg/hr infusion. Infusion was continued up to four hours during surgery and till eight hours of postoperative in both groups. Haemodynamic parameters {Heart Rate (HR), Mean Arterial Pressure (MAP)} were recorded after start of study drug infusion, after intubation, then every 15 minutes till 1 hour, then every 30 minutes till end of surgery and after extubation. In postoperative period, HR and MAP were recorded at interval of one hour till eight hours after extubation and postoperative analgesia was assessed by Visual Analogue Scale (VAS) at interval of one hour till eight hours. Present study used descriptive statistical analysis for data analysis. Analysis of variance (ANOVA) was used to compare data between two groups. Chi-square test was used to find the significance of difference on categorical scale between two groups. Results: This study showed that group-B had significantly less VAS score most of time in recovery period as compared to group-A (1.97±0.18 vs 2.10±0.31 at eight hours postoperative). HR, MAP was found significantly less all the time during surgery and most of the time postoperatively in group-B (p-value <0.05). Conclusion: Intravenous infusion of dexmedetomidine can be better for controlling postoperative pain and perioperative haemodynamic stability as compared to infusion of fentanyl in patients undergoing abdominal surgeries.

scholarly journals Flap design: Comparison of ward’s flap versus modified ward’s flap in surgical extraction of impacted mandibular third molar.

2019 ◽  
Vol 26 (08) ◽  
pp. 1323-1327
Author(s):  
Ashook Kumar ◽  
Anny Memon ◽  
Suneel Kumar Panjabi ◽  
Salman Shams
Keyword(s):  
Postoperative Pain ◽  
Third Molar ◽  
P Value ◽  
Full Thickness ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Flap Design ◽  
Mucoperiosteal Flap ◽  
Group A ◽  
Group B

To compare the Ward’s Flap Versus Modified Ward’s flap in relation to access, healing & postoperative complications in surgical extraction of mandibular third molar impaction. Study Design: Comparative Cross Sectional. Setting: Department of Oral & Maxillofacial Surgery LUMHS Jamshoro/Hyderabad: Period: March 2017 to November 2017. Materials and Methods: The history, clinical examination and radiographs (OPG and periapical) had done by team of researchers and recorded on proforma. After selection of patient into either group (Group A=Wards Flap, Group B Modified Wards), the surgical extraction was carried out under local anesthesia. For group A, a standard full thickness mucoperiosteal flap (ward’s flap) was raised. The incision was given mesial to the impacted lower third molar. For group B, a standard full thickness mucoperiosteal flap (Modified ward’s flap) was given mesial to second molar. At the end of the surgery, the flap design used for the extraction of impacted lower third molar tooth and the duration of each operation (from the first extraction maneuver to the completion of the last suture), Pain, Swelling and Trismus13 were recorded on the proforma. Every patient was called for follow up on the 3rd day and 7th day. Results: Mean age was found 27.93 years, with range of minimum 20 years and maximum 35 years. Male were found in the majority 72.3%. Majority of the cases 51.5% were found with class B, in class A 37.5% and 10.9% were found with class C. According to the impaction position 50% cases were in class I, and 50% cases were in class II. Preoperative pain measurement was done according VAS, 71.9% patients were found with mild pain, 9.4% were with moderate pain while 18.8% patients were without pain. Modified Wards flap showed good efficacy regarding duration of third molar extraction as compare to Ward’s flap P-value 0.018. Modified ward’s flap had showed less postoperative pain as compare to ward’s flap p-value 0.022. No significant difference was found between both groups on 3rd and 7th postoperative day in Mouth opening. Conclusion: This study concluded that both ward’s flap and modified ward’s flaps showed good efficacy, while duration of surgery and postoperative pain were significantly less in the modified ward’s flaps as compare to ward’s flap. More large sample size studies are required to evaluate more accurate findings.

scholarly journals Comparison of Postoperative Pain Control Methods after Bony Surgery of the Foot and Ankle

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Gi-Soo Lee ◽  
Chan Kang ◽  
Yoo Jung Park ◽  
June Bum Jun ◽  
Byung Hak Oh ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sciatic Nerve ◽  
Pain Control ◽  
Control Methods ◽  
Foot And Ankle ◽  
Ultrasound Guided ◽  
Postoperative Pain Control ◽  
Bone Surgery ◽  
Group A ◽  
Group B

Category: Ankle, Pain Introduction/Purpose: We performed a prospective study to evaluate and compare the effectiveness of postoperative pain control methods after bone surgery of the foot and ankle. Methods: Among the patients who underwent foot and ankle surgery from June 2014 to September 2015 with an ultrasound- guided nerve block, 84 patients who fully completed a postoperative pain survey were enrolled. An opioid patch (fentanyl patch, 25 mg) was applied in group A (30 patients), diluted anesthetic (0.2% ropivacaine, 30 ml) was injected into the sciatic nerve once, about 12 hours after the pre-operative nerve block in group B (27 patients), and periodic analgesic intramuscular injection (ketorolac (Tarasyn? R), 30 mg) was performed in group C (27 patients). Visual analog scale (VAS) pain scores at 6, 12, 18, 24, and 48 hours after surgery were checked, and complications of all methods were surveyed. Results: The mean VAS pain score was lower in group B, with a statistically significantly difference (p < .05) between groups A, B, and C at 12 and 18 hours after surgery. Four patients in group A suffered from nausea and vomiting, whereas no other patients complained of any complications or side effects. Conclusion: The ultrasound-guided injection of diluted anesthetic into the sciatic nerve seemed to be the most useful method for controlling pain in the acute phase following foot and ankle bone surgery. By injecting the diluted anesthetic once on the evening of the day of surgery, patients suffered less postoperative pain.

The Effects of Timing of Ankle Blocks in Forefoot, Midfoot, or Hindfoot Reconstruction With the Use of an Ankle Tourniquet

2018 ◽  
Vol 11 (6) ◽  
pp. 527-533
Author(s):  
James Gwosdz ◽  
Lattisha Bilbrew ◽  
Daniel Jupiter ◽  
Vinod Panchbhavi
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Randomized Study ◽  
Comparative Trial ◽  
Vas Score ◽  
Level Ii ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Tourniquet Inflation

Background. Ankle blocks are used in the ambulatory surgery setting to control postoperative pain, which is often worst in the first 24 hours after surgery. We conducted a trial to determine whether the timing of ankle block administration in relation to ankle tourniquet inflation has an effect on perceived pain and narcotic consumption. Methods. A prospective randomized study was conducted between August 2015 and January 2016. Patients were assigned to three groups. In group A, an ankle block was performed before ankle tourniquet inflation; in group B, immediately after ankle tourniquet inflation; and in group C, immediately after ankle tourniquet inflation with additional local anesthetic placed around the incision at the end of the procedure. Pain was assessed by a visual analogue scale (VAS) score, which was recorded at discharge, 24 hours, 48 hours, and 2 weeks after surgery. Narcotic consumption was recorded at 24 and 48 hours after surgery. Results. The only statistically significant difference in mean VAS scores occurred at 24 hours, when patients who received an ankle block after tourniquet inflation with local incisional anesthetic at closure (group C) had a mean VAS score 2.8 points lower (3.5 vs 6.3; P = .025) than those who received only an ankle block after tourniquet inflation (group B). There was no difference in narcotic consumption between groups at 24 and 48 hours. Conclusions. The timing of ankle block in relation to tourniquet inflation did not have an effect on pain control in forefoot, midfoot, and hindfoot reconstruction. The synergistic effect of an ankle block with additional incisional anesthetic at closure, is more effective than ankle block alone and is the ideal combination for postoperative pain control in foot surgery. Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial

scholarly journals Efficacy of various administrative techniques of methylprednisolone on oedema, trismus and pain after lower third molar surgery

2017 ◽  
Vol 5 (2) ◽  
pp. 186 ◽  
Author(s):  
Vaibhav Mukund ◽  
Sukumar Singh ◽  
Sanjeev Kumar ◽  
Rishi Rath ◽  
Siddharth Tevatia
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Routes Of Administration ◽  
Group A ◽  
Maximal Mouth Opening ◽  
Level Of Significance ◽  
Group B

Due to their anatomical position, the surgical removal of impacted third molars results in oedema, pain, and trismus. The purpose of this study was to evaluate the efficacy of four different routes of administration of methylprednisolone on oedema, trismus and pain after lower third molar surgery. This randomized, perspective, and controlled study included 150 patients. The patients were randomly divided into five groups: Group A (control; no steroids), Group B (Submucosal injection), Group C (oral tablets), Group D (i.v. injection) and Group E (Intramuscular Injection). On days 2 and 7 following surgery, linear oedema was determined using facial landmarks, and maximal mouth opening was measured. Postoperative mouths opening and swelling were evaluated for each route of methylprednisolone administration and compared. The female (59%) to male (41%) ratio was 1.44; the mean age of the patients was 29.6 years. The level of significance was set at P < 0.01 for mouth opening and P < 0.05 for oedema. With regard to trismus, all four routes of administration demonstrated better efficacy in comparison to the control. While oral administration and i.v. injection of methylprednisolone achieved similar results, masseter injection provided better results in reducing oedema and trismus when compared with the control following lower third molar surgery.

Multimodal analgesia combined with intravenous administration of acetaminophen in perioperative management of esophagectomy using modified ERAS protocol.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 94-94 ◽  
Author(s):  
Takashi Ogata ◽  
Tetsushi Nakajima ◽  
Kazuki Kano ◽  
Kenki Segami ◽  
Yukio Maezawa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Perioperative Management ◽  
Breakthrough Pain ◽  
Early Mobilization ◽  
Multimodal Analgesia ◽  
Analgesic Drug ◽  
Group A ◽  
Group B ◽  
Eras Protocol

94 Background: In perioperative management of esophagectomy, we have performed modified ERAS protocol including preoperative oral rehydration, early enteral nutrition, early mobilization, intestinal peristalsis promotion, pain control, and so on. We think these elements are related closely and useful in reducing complication and early recovery after surgery in case of high invasive surgery such as esophagectomy with 3 field lymph node dissection. And we think pain control is particularly close relationship with early mobilization, so multimodal analgesia is very important for postoperative pain control. Methods: We evaluated whether it is possible to reduce postoperative breakthrough pain by using postoperative pain control combined with acetaminophen IV. 124 patients were treated by esophagectomy with 3-field LN dissection from January 2013 to June 2015. Before May 2014, 49 patients were treated without acetaminophen IV protocol (Group A), and after May 2014, 75 patients were treated with acetaminophen IV protocol (Group B). We compared the number of analgesic drug until postoperative day 7, and compared the ratio of liver dysfunction in both groups. Both groups were used epidural anesthesia as postoperative pain management, and intravenous administration of acetaminophen 1000mg/day has been added between day3 to day 7 in Group B. Results: The number of analgesic drug use due to breakthrough pain(Group A / Group B) were day3:1.12/0.55, day4:1.58/0.83, day5:1.76/0.57, day6:1.24/0.49, and it was reduced significantly in Group B (p < 0.01). And liver damage as a side effect by acetaminophen IV, the rise of ALT(Group A / Group B) were seen 32.7%/66.7% in day6, and seen 20.4%/62.7% in day 8, and it was significantly higher in Group B at day6 and day8 (p < 0.01), but was no significant difference in day 30 between both groups. Conclusions: In perioperative management of esophagectomy, pain control combined with acetaminophen IV was useful as multimodal analgesia. Also was ALT rise is seen by liver damage, but it was the minor change in the acceptable range for natural healing.

scholarly journals Electro-acupuncture efficacy on pain control after mandibular third molar surgery

2007 ◽  
Vol 18 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Marconi Gonzaga Tavares ◽  
Ana Paula Machado ◽  
Breno Gutierrez Motta ◽  
Maria Cristina Borsatto ◽  
Adalberto Luiz Rosa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Young Patients ◽  
Third Molar ◽  
Contralateral Side ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Mandibular Third Molar ◽  
Mandibular Third Molar Surgery ◽  
Mandibular Third Molars

The aim of this study was to evaluate the efficacy of electro-acupuncture (EAC) on postoperative pain control after mandibular third molar surgery. Twenty four young patients (12 male and 12 female) with symmetrically impacted mandibular third molars were selected. Each patient was submitted to two separate surgical procedures under local anesthesia. At one side, extraction was carried out employing both prior (24h) and immediately postoperative application of EAC, while on the contralateral side surgery was carried out without any treatment. EAC was applied on 6 bilateral systemic and 2 auricular points with a WQ10Dl appliance using 40-60Hz frequency for 20 min and individually adjusted intensity. Postoperative pain intensity was rated on a 100 mm visual analog scale (VAS) between 2 and 72 h and recording the amount of analgesics intake after surgery. Statistical analysis was performed using theWilcoxon test. Postoperative pain VAS scores were significantly lower for the EAC group (p<0.05) and analgesic intake decreased (p<0.05) for all evaluated periods (p<0.05). Under the tested conditions EAC therapy is efficient was proved controlling postoperative pain following mandibular third molar surgical removal.

scholarly journals Can Combination of Peripheral Nerve Block and Non-opioidal Patient Controlled Analgesia Be an Effective Postoperative Pain Control Method?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0023
Author(s):  
Chan Kang ◽  
Gi Soo Lee ◽  
Dong Yeol Kim ◽  
Jeong-kil Lee ◽  
Ki Jun Ahn ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Control ◽  
Control Method ◽  
Patient Controlled Analgesia ◽  
Ultrasound Guided ◽  
Bone Surgery ◽  
Pain Scores ◽  
Group A ◽  
Group B

Category: Ankle, Pain medicine Introduction/Purpose: Even though bone surgery is very painful after operation, there is no established method to control postoperative pain due to efficacy and side effects. Ultrasound-guided peripheral nerve block (PNB) and nonsteroidal anti- inflammatory drugs (NSAIDs) patient controlled analgesia (PCA) can effectively control pain and reduce side effects. Methods: We conducted a prospective study of 150 patients over 18 years of age who underwent bone surgery from June 2018 to December 2018. All operations were performed under anesthetic ultrasound-guided PNB and additional PNB was performed to control postoperative pain. Among the 120 patients who participated in the final study, NSAIDs PCA was used in group A (65 patients) and NSAIDs PCA was not used in group B (55 patients) for pain control. Postoperative management except PCA was same in both groups. Pain scores are measured at 6, 12, 18, 24, 36, 48, and 72 hours after the operation and they were compared using visual analogue scale (VAS) pain scores. Survey was done on satisfaction of patients, and their willingness to reconsider same method of pain control when they undergo same surgery next time. Also, we evaluated possible side effects that might happen during process of controlling pain. Results: VAS pain score were significantly different only at 24 h postoperatively (p=0.004). In Group A, three patients were prescribed 3 amples of pethidine intramuscular injection as rescue analgesic. In group B, 35 patients were prescribed 50 amples of pethidine and 12 patients of them were received additional 18 amples of ketorolac intramuscular injection as rescue analgesic(p=0.000). In group A, all patients were satisfied with the pain control method, but 5 of the group B patients were dissatisfied (p=0.001). 3 patients responded to severe pain after operation and 2 of them due to postoperative nausea and vomiting (PONV). In group A, there were no patients complaining of PONV, but in group B, 5 patients complained of symptoms (p=0.018), and 3 of them were prescribed additional antiemetics (p=0.093). Conclusion: Combined use of ultrasound-guided PNB and NSAIDs PCA seems to be an effective postoperative pain control method in foot and ankle surgery. Because, pain can be effectively controlled and PONV can be reduced.

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