scholarly journals The Effect of Intravenous Magnesium Sulfate Infusion on Sensory Spinal Block and Postoperative Pain Score in Abdominal Hysterectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Fatih Kahraman ◽  
Ahmet Eroglu
Keyword(s):  
Postoperative Pain ◽  
Spinal Anesthesia ◽  
Magnesium Sulphate ◽  
Abdominal Hysterectomy ◽  
Control Group ◽  
Spinal Block ◽  
Double Blind ◽  
Arterial Blood ◽  
Vas Scores ◽  
And Control

Aim. The aim of this study was to investigate the effect of i.v. infusion of magnesium sulphate during spinal anesthesia on duration of spinal block and postoperative pain.Methods. Forty ASA physical status I and status II, aged between 18 and 65, female patients undergoing abdominal hysterectomy under spinal anesthesia were enrolled in this study. Patients in the magnesium group (Group M,n= 20) received magnesium sulphate 65 mg kg−1infusion in 250 mL 5% dextrose at 3.5 mL/min rate, and control group (Group C,n= 20) received at the same volume of saline during operation in a double-blind randomized manner. Duration of sensory and motor block, systolic, diastolic, and mean arterial blood pressures, heart rates, pain scores (VAS values), and side effects were recorded for each patient. Blood and CSF samples were taken for analysis of magnesium concentrations.Results. Regression of sensorial block was longer in Group M when compared with that in Group C (175 ± 39 versus 136 ± 32 min) (P< 0.01). The VAS scores were lower in Group M than those in Group C at the 2 time points postoperatively (P< 0.01).Conclusion. 65 mg kg−1of magnesium sulphate i.v. infusion under spinal anesthesia prolongs spinal sensorial block duration and decreases pain VAS scores without complication in patients undergoing abdominal hysterectomy.

scholarly journals Intraoperative Intercostal Nerve Block for Postoperative Pain Control in Pre-Pectoral versus Subpectoral Direct-To-Implant Breast Reconstruction: A Retrospective Study

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 325 ◽  
Author(s):  
Jin-Woo Park ◽  
Jeong Hoon Kim ◽  
Kyong-Je Woo
Keyword(s):  
Postoperative Pain ◽  
Breast Reconstruction ◽  
Intercostal Nerve ◽  
Control Group ◽  
Intercostal Nerve Block ◽  
Nerve Blocks ◽  
Vas Score ◽  
Vas Scores ◽  
Lower Maximum ◽  
And Control

Background and Objectives: Patients undergoing mastectomy and implant-based breast reconstruction have significant acute postsurgical pain. The purpose of this study was to examine the efficacy of intercostal nerve blocks (ICNBs) for reducing pain after direct-to-implant (DTI) breast reconstruction. Materials and Methods: Between January 2019 and March 2020, patients who underwent immediate DTI breast reconstruction were included in this study. The patients were divided into the ICNB or control group. In the ICNB group, 4 cc of 0.2% ropivacaine was injected intraoperatively to the second, third, fourth, and fifth intercostal spaces just before implant insertion. The daily average and maximum visual analogue scale (VAS) scores were recorded by the patient from operative day to postoperative day (POD) seven. Pain scores were compared between the ICNB and control groups and analyzed according to the insertion plane of implants. Results: A total of 67 patients with a mean age of 47.9 years were included; 31 patients received ICNBs and 36 patients did not receive ICNBs. There were no complications related to ICNBs reported. The ICNB group showed a significantly lower median with an average VAS score on the operative day (4 versus 6, p = 0.047), lower maximum VAS scores on the operative day (5 versus 7.5, p = 0.030), and POD 1 (4 versus 6, p = 0.030) as compared with the control group. Among patients who underwent subpectoral reconstruction, the ICNB group showed a significantly lower median with an average VAS score on the operative day (4 versus 7, p = 0.005), lower maximum VAS scores on the operative day (4.5 versus 8, p = 0.004), and POD 1 (4 versus 6, p = 0.009), whereas no significant differences were observed among those who underwent pre-pectoral reconstruction. Conclusions: Intraoperative ICNBs can effectively reduce immediate postoperative pain in subpectoral DTI breast reconstruction; however, it may not be effective in pre-pectoral DTI reconstruction.

scholarly journals A Comparative Study on the Effects of Acupressure at SP6 and ST36 Acupoints on the Pain Caused by Fistula Needle Placement in Hemodialysis Patients

2021 ◽  
Vol 10 (4) ◽  
pp. 354-367
Author(s):  
Tahereh Baloochi Beydokhti ◽  
Keyword(s):  
Arteriovenous Fistula ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Needle Placement ◽  
Chi Square ◽  
Double Blind ◽  
Significant Difference ◽  
Chi Square Test ◽  
Vas Scores ◽  
And Control

Objective: Hemodialysis is one of the most common treatment methods in kidney patients. To do this, repeated insertion of the needle into the vessel is necessary. Patients treated with hemodialysis are exposed to stress and pain caused by perforation of their arteriovenous fistula about 300 times a year. More than 1/5 of hemodialysis patients express this pain as unbearable. This study aims to evaluate the effect of acupressure at SP6 and ST36 acupoints on the pain caused by fistula needle placement in hemodialysis patients. Methods: This study is a double-blind randomized clinical trial conducted in 2016 on 90 hemodialysis patients with arteriovenous fistula in Mashhad, Iran. They were randomly divided into three groups of SP6, ST36, and control. Data were collected after obtaining a written informed consent by a demographic form and the Visual Analog Scale (VAS). Data analysis was performed in SPSS v.16 software by using Kolmogorov-Smirnov test, Kruskal-Wallis test, one-way ANOVA, paired t-test, and Chi-square test. Results: There was a statistically significant difference between VAS scores after the intervention in all three group (P<0.001). The Mean±SD VAS scores before the intervention in SP6, ST36, control groups were 54.47±18.93, 51.5±22.83, 46.6±17.73, respectively which changed to 45.63±20.53, 40.2±20.01, and 51.87±19.05 after the intervention, indicating that acupressure at SP6 and ST36 acupoints reduced pain in patients, while the pain increased in the control group. Conclusion: Acupressure at SP6 and ST36 acupoints is an effective method in relieving pain caused by the insertion of a needle into the arteriovenous fistula in hemodialysis patients.

scholarly journals Combined Subcostal and Posterior Transversus Abdominis Plane Block for Postoperative Pain Relief after Abdominoplasty: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Haytham El Sayed ◽  
A Shaheed Fadhul ◽  
Mohamed Al Falaki ◽  
M Nasr Awad
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Control Group ◽  
Transversus Abdominis Plane ◽  
Esthetic Surgery ◽  
Analgesic Regimen ◽  
Vas Scores ◽  
And Control

Abstract Background: Abdominoplasty is a common esthetic surgery for adequate pain management during the postoperative period. Transversus abdominis plane block (TAPB) is a therapeutic complement for analgesia for postoperative pain following abdominal surgery.Aim: To compare the outcomes of TAPB and systemic opioids in patients undergoing abdominoplasty.Methods: Fifty-eight patients undergoing abdominoplasty were randomly assigned to two groups: Combined subcostal and posterior TAPB group (BG, n=29) and Control group (CG, n=29). The standard postoperative analgesic regimen for both groups consisted of IV Paracetamol 1 g every 6 h. The visual analog scale (VAS) scores for pain were recorded postoperatively, and once the patient had a VAS ≥4, IV pethidine was administered. The primary outcome was pethidine consumption in the first 72 h postoperatively; the secondary outcomes included VAS scores at rest and during movement in the first 72 h postoperatively, time to first ambulation, and time to first incentive spirometer at 900 mL/min.Results: Pethidine consumption in the first 72 h was 208.62±85.64 in the CG group and 20.69±25.06 in BG (p<0.05). VAS was lower in BG during the first 72 h both at rest and during movement (p<0.05). Time to first ambulation was 12.41±5.04 h in the CG group and 4.62±1.08 h in BG (p<0.05), time to first incentive spirometer at 900 mL/min was 11.45±5.05 h in CG and 4.27±1.09 h in BG (p<0.05).Conclusion: Combined subcostal and posterior TAPB offers a longer postoperative analgesic effect and reduced postoperative opioid requirements with fewer postoperative complications.Trial RegistrationClinical Trial: TCTR20200602001 “Retrospectively registered”Date of registration on May 30, 2020.

scholarly journals The Effect of Intravenous Magnesium Sulphate as an Adjuvant in the Treatment of Acute Exacerbations of COPD in the Emergency Department: A Double-Blind Randomized Clinical Trial

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Fatemeh Jahanian ◽  
Iraj Goli Khatir ◽  
Hamed Amini Ahidashti ◽  
Sepideh Amirifard
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Magnesium Sulfate ◽  
Magnesium Sulphate ◽  
Intervention Group ◽  
Control Group ◽  
Double Blind ◽  
Intravenous Magnesium ◽  
Acute Exacerbations ◽  
And Control

BACKGROUND፡ Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are serious complications that often require immediate intervention in an emergency department (ED). The aim of this study was to investigate the effect of intravenous magnesium sulphate as an adjuvant in the treatment of AECOPD in the ED.METHODS: In a double-blind, randomized clinical trial, a total of 60 patients with AECOPD presenting to the ED of Imam Khomeini Hospital in Sari, Iran, were included. The study was conducted between September 2016 and February 2018. Eligible patients were randomly allocated into two groups of intervention and control. Patients in the intervention and control groups received intravenous infusion of magnesium sulfate (2 gr) or normal saline over 30 minutes, respectively. For all patients, Borgdyspnea score, forced expiratory volume in one second (FEV1) result and clinical variables of interest were evaluated before the beginning of the intervention, and also 45 minutes and 6 hours after the commencement of intervention.RESULTS: Regardless of time of evaluation, pulse rate (PR), respiratory rate (RR) and Borg score in intervention group was lower than control group. Also, FEV1 and SPO2 were greater in intervention group compared to control group. However, these differences were not statistically significant (between-subject differences or group effect) (p<0.001). The trends of FEV1, SPO2, PR, RR and Borg score were similar between two groups of study (no interaction effect; P>0.05).CONCLUSION: According to the results of this study, it seems that using intravenous magnesium sulfate has no significant effect on SPO2, FEV1, RR, and PR of patients with AECOPD who presented to ED.

scholarly journals Effect of IV Infusion of Magnesium Sulfate on Postoperative Pain after Spinal Anesthesia: A Prospective Randomized Trial

2021 ◽  
Author(s):  
Shubhi Singhal ◽  
Devang Bharti ◽  
Sangeeta Yadav ◽  
Nitin Hayaran
Keyword(s):  
Postoperative Pain ◽  
Magnesium Sulfate ◽  
Spinal Anesthesia ◽  
Lower Limb ◽  
Controlled Study ◽  
Control Group ◽  
Analgesic Requirement ◽  
Group I ◽  
Significant Difference ◽  
Vas Scores

Background: The current study attempts to evaluate the effect of intravenous (IV) infusion of magnesium sulfate during spinal anesthesia on postoperative pain and postoperative analgesic requirements in lower limb surgeries. Methods: In this double blind, randomized controlled study, 60 patients undergoing elective lower limb surgeries, were selected and randomly divided into two groups. Group I received isotonic saline and group II was administered magnesium sulfate 50 mg Kg-1 IV for 15 min and then 15 mg Kg-1 h-1 by continuous IV infusion till the end of surgery or 2 hours, whichever was earlier. Ramsay sedation scores, VAS scores for pain, time of first administration of rescue analgesic and total analgesic requirement were noted in both the groups. Results: Statistically significant difference was observed in the VAS score between the two groups at 1st, 2nd, 3rd, 6th, 9th and 12th hour intervals; with VAS scores being lower in the magnesium group (p<0.05). The mean time of first rescue analgesic requirement in control group was 144.00 mins, while in magnesium group was 246.00 mins (p<0.05). The total rescue analgesic requirement was found to be 251.67 mg and 181.67 mg at the end of 24 hours, in control and magnesium groups, respectively (p<0.05). Conclusion: This study demonstrates statistically significant lowering of postoperative VAS scores, delayed need of postoperative analgesia and reduced total postoperative analgesic requirement in patients receiving intraoperative IV magnesium sulfate compared to the control group. Magnesium sulfate did not cause sedation or any other significant adverse effect in the doses used in the study.

scholarly journals Pain Management Using Perioperative Administration of Parecoxib for Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial

2019 ◽  
Vol 6 (22;6) ◽  
pp. 575-582
Author(s):  
Xisheng Weng
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Total Hip Arthroplasty ◽  
Bleeding Risk ◽  
Morphine Consumption ◽  
Control Group ◽  
Double Blind ◽  
Perioperative Bleeding ◽  
Vas Scores ◽  
Length Of Hospitalization

Background: Controlling postoperative pain and improving outcomes after total hip arthroplasty (THA) remain an important challenge, which affects the functional recovery of the hip. Objectives: To assess the effect of preemptive administration of the selective cyclooxygenase-2 inhibitor parecoxib sodium (PS) after THA. Study Design: A prospective, randomized, double-blinded clinical trial. Setting: An academic medical center. Methods: This randomized double-blind clinical trial compared postoperative analgesia intervention for unilateral primary THA. Patients were assigned in a 1:1 ratio to the PS group and the control group. The PS group received 40 mg dose of PS 30 minutes before incision, 12 hours after THA, and every 12 hours for 2 days postoperatively, and the control group received normal saline solution at the same time point. In addition, both groups received patient-controlled intravenous analgesia of morphine. Perioperative visual analog scale (VAS) scores, cumulative morphine consumption, functional recovery, perioperative bleeding risk, and the selected indicators of the inflammatory response were compared between the PS group and the control group. Results: From October 2014 to June 2015, 180 patients undergoing unilateral primary THA were screened for this prospective clinical trial. A total of 141 patients were enrolled and randomly assigned into the PS group (n = 69) and the control group (n = 72). Compared with the control group, VAS scores at rest were significantly lower in the PS group at 4, 12, and 24 hours after surgery, and VAS scores during movement were also lower in the PS group at 4, 12, 24, 36, and 48 hours after surgery (all P < 0.001). Both the cumulative morphine consumption and its associated nausea and vomiting were reduced in the PS group (P < 0.001 and P = 0.021, respectively). The length of hospitalization in the PS group was shorter than the control group (PS group 5.91 ± 1.15 days, control group 6.41 ± 1.49 days; P = 0.019). The PS group had lower body temperature than the control group at postoperative day (POD) 1 (P = 0.003) and POD 3 (P = 0.001), and the levels of high-sensitivity C-reactive protein in the PS group at POD 3 (P = 0.016) and POD 6 (P = 0.006) were also lower than those in the control group. The concentration of interleukin (IL)-6 and IL-10 were significantly different between the 2 groups (IL-6, P = 0.007; IL-10, P = 0.006) on the first day postoperatively. The PS group was not significantly different from the control group with respect to any outcomes: blood loss, postoperative blood drainage and blood transfusion, and number of days needed to accomplish straight-leg raising and off-bed exercise. Limitations: PS was used only until POD 2, and there was no long-term follow-up. Conclusions: Perioperative administration of PS is an effective addition to a multimodal regimen that alleviates postoperative pain, reduces the cumulative morphine consumption, length of hospitalization, and perioperative inflammatory response, without increasing perioperative bleeding risk.

The Effect of Early Warm Plastic Bag Application on Postoperative Pain after Hemorrhoidectomy: A Prospective Randomized Controlled Trial

2015 ◽  
Vol 81 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Ahmet Ziya Balta ◽  
Yavuz Ozdemir ◽  
Ilker Sucullu ◽  
Aliilker Filiz ◽  
Ergun Yucel ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Resting State ◽  
Controlled Trial ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Early Application ◽  
Significant Difference ◽  
Plastic Bag ◽  
Vas Scores ◽  
And Control

Hemorrhoidectomy is used for the surgical treatment of high-grade hemorrhoids. The most prominent complaint after hemorrhoidectomy is pain. Postoperative pain management is still a big problem after surgery in patients with hemorrhoidectomy. The aim of the study was to assess the effect of early application of warm bag on postoperative pain after hemorrhoidectomy. All patients were randomly divided into warm plastic bag and control groups by using sealed envelopes, which were prepared preoperatively. After standard spinal anesthesia, all patients underwent standard Milligan-Morgan hemorrhoidectomy using Ligasure™. Although the study group received the warm bag application, the control group did not receive such a treatment. Two separate visual analog scale (VAS) measurements were performed for postoperative pain assessments on postoperative days, one during the resting state and the other one during the straining phase after the onset of peristaltic bowel movement. Postoperative VAS scores were significantly lower among the warm plastic bag group as compared with the control group on Days 1 and 3 for the resting state and on Day 3 for defecation. Additionally, a significant difference existed between the two groups in terms of the need for additional anesthesia. Local thermal application appears to be a safe and effective method for pain relief after hemorrhoidectomy.

scholarly journals Ketamine versus dexmedetomidine as an adjuvant in ultrasound-guided supraclavicular brachial plexus block: A double-blind randomized clinical trial

2021 ◽  
Author(s):  
Ahmed mohmed ◽  
Abeer Hassanein ◽  
Haidy Mansour
Keyword(s):  
Postoperative Pain ◽  
Brachial Plexus ◽  
Nerve Block ◽  
Brachial Plexus Block ◽  
Control Group ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Supraclavicular Brachial Plexus Block ◽  
Vas Scores ◽  
Plexus Block

Abstract Background: Peripheral nerve block has gained increased popularity due to less postoperative pain, reduced need for postoperative analgesic drugs, reduction of PACU time, and improved patient satisfaction. The aim of the study was to compare the effect of ketamine and dexmedetomidine as additives to bupivacaine on onset and duration of the block, post-operative VAS, and analgesic consumption, after ultrasound-guided supraclavicular nerve block. Methods: 75 adult patients undergoing elective operations of the elbow, forearm, wrist, or hand were randomly allocated into three groups of 25 patients each. Group K (ketamine group) received 40 ml 0.25% bupivacaine contain 1 mg/kg ketamine, Group D (dexmedetomidine group) received 40 ml 0.25% bupivacaine contain 1ug/kg dexmedetomidine, group C (control group) received 40 ml 0.25% bupivacaine. The outcome measures included visual analog scale (VAS, 0 = no pain 10 cm = the most severe pain), time to first analgesic request, and total dose of diclofenac analgesia given postoperatively. Sedation score also recorded in all groups Results: Patients in D and K groups had reduced VAS scores than the C group, at all-time points after surgery during the first 24 hours, with more reduction in D than K group ( P < 0.05). The time of the first analgesic request in the D group was significantly more than in the K group and both were more than the C group (9.48±1.417 h, 7.08 ±1.255 h, and 5.00 ± 1.04 h respectively). Conclusions: The addition of ketamine or dexmedetomidine in the ultrasound-guided supraclavicular brachial plexus block could improve the postoperative pain and need for analgesia. Therefore, we can consider the low price more available ketamine as a comparable adjuvant in brachial plexus block to some extent as dexmedetomidine. Trial registration: https://www.clinicaltrials.gov/ct2/show/NCT04508894, Date of registration (02/21/2019).

PREEMPTIVE ANALGESIA WITH AMITRIPTYLINE IN WOMEN UNDERGOING ABDOMINAL HYSTERECTOMY: A RANDOMIZED CLINICAL TRIAL

2020 ◽  
pp. 2-5
Author(s):  
Antônio Henriques De França Neto ◽  
Alexandre Magno Nóbrega Marinho ◽  
Eveline Pereira De Arruda Agra ◽  
Priscilla Guimarães Alves ◽  
Josikwylkson Costa Brito ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Pressure Pain Threshold ◽  
Abdominal Hysterectomy ◽  
Tricyclic Antidepressant ◽  
Preemptive Analgesia ◽  
Chi Square ◽  
Double Blind ◽  
Exact Test ◽  
Student’S T

The concept of preemptive analgesia, albeit long-standing, has reemerged. Consequently, recent research has focused on testing a variety of drugs preoperatively to prevent the occurrence of postoperative pain, a major factor of morbidity. Amitriptyline is a tricyclic antidepressant used to treat chronic pain. Because amitriptyline acts on pain transmission pathways, it could theoretically be used as an agent for the prevention of postoperative pain. This study evaluated the effectiveness of amitriptyline in preventing pain in patients submitted to hysterectomy, the most commonly performed gynecological surgery. A randomized, double-blind clinical trial was conducted with 145 patients, 72 of these receiving amitriptyline and 73 placebo. All patients were evaluated at 6, 12, 24 and 48 hours after surgery using a visual analog scale (VAS) for pain and algometry to determine the pressure-pain threshold. Statistical analysis was conducted using the chi-square test of association, Student's t-test, and the Mann-Whitney test, with Fisher's exact test being used whenever appropriate. No statistically signicant difference was found between the two groups with respect to pain at any of the time points evaluated, leading to the conclusion that at a dose of 25 mg, amitriptyline is ineffective in preventing postoperative pain in patients submitted to abdominal hysterectomy

scholarly journals Predicted Versus Non-Predicted Opioid Administration Using Preoperative Pain Sensitivity in Patients Undergoing Gynecological Surgery: A Randomized-Controlled Trial

2021 ◽  
Vol 10 (4) ◽  
pp. 585
Author(s):  
Sun-Kyung Park ◽  
Hansol Kim ◽  
Seokha Yoo ◽  
Won Ho Kim ◽  
Young-Jin Lim ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Sensitivity ◽  
Control Group ◽  
Gynecological Surgery ◽  
Control Groups ◽  
Preoperative Pain ◽  
Pain Scores ◽  
Pressure Pain Thresholds ◽  
Opioid Administration ◽  
And Control

Individualized administration of opioids based on preoperative pain sensitivity may improve postoperative pain profiles. This study aimed to examine whether a predicted administration of opioids could reduce opioid-related adverse effects after gynecological surgery. Patients were randomized to the predicted group or control group. Participants received a preoperative sensory test to measure pressure pain thresholds. Patients were treated with a higher or lower (15 or 10 μg/mL) dose of fentanyl via intravenous patient-controlled analgesia. The opioid dose was determined according to pain sensitivity in the predicted group, while it was determined regardless of pain sensitivity in the control group. The primary outcome was the incidence of nausea over the first 48 h postoperative period. Secondary outcomes included postoperative pain scores and opioid requirements. There was no difference in the incidence of nausea (40.0% vs. 52.5% in predicted and control groups, respectively; p = 0.191) and postoperative pain scores (3.3 vs. 3.5 in predicted and control groups, respectively; p = 0.691). However, opioid consumptions were lower in the predicted group compared to the control group (median 406.0 vs. 526.5 μg; p = 0.042). This study showed that offering a predicted dose of opioids according to pain sensitivity did not affect the incidence of nausea and pain scores.

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