scholarly journals Comparison of Propofol, Propofol-Remifentanil, and Propofol-Fentanyl Administrations with Each Other Used for the Sedation of Patients to Undergo ERCP

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Candan Haytural ◽  
Bahar Aydınlı ◽  
Berna Demir ◽  
Elif Bozkurt ◽  
Erkan Parlak ◽  
...  
Keyword(s):  
Total Dose ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Randomized Study ◽  
Anesthetic Agent ◽  
Group Iii ◽  
Group I ◽  
Numerical Rating ◽  
Group Ii ◽  
High Doses

Introduction. Using single anesthetic agent in endoscopic retrograde cholangiopancreatography (ERCP) may lead to inadequate analgesia and sedation. To achieve the adequate analgesia and sedation the single anesthetic agent doses must be increased which causes undesirable side effects. For avoiding high doses of single anesthetic agent nowadays combination with sedative agents is mostly a choice for analgesia and sedation for ERCP.Aim. The aim of this study is to investigate the effects of propofol alone, propofol + remifentanil, and propofol + fentanyl combinations on the total dose of propofol to be administered during ERCP and on the pain scores after the process.Materials and Method. This randomized study was performed with 90 patients (ASA I-II-III) ranging between 18 and 70 years of age who underwent sedation/analgesia for elective ERCP. The patients were administered only propofol (1.5 mg/kg) in Group Ι, remifentanil (0.05 μg/kg) + propofol (1.5 mg/kg) combination in Group II, and fentanyl (1 μg/kg) + propofol (1.5 mg/kg) combination in Group III. All the patients’ sedation levels were assessed with the Ramsey Sedation Scale (RSS). Their recovery was assessed with the Aldrete and Numerical Rating Scale Score (NRS) at 10 min intervals.Results. The total doses of propofol administered to the patients in the three groups in this study were as follows: 375 mg in Group I, 150 mg in Group II, and 245 mg in Group III.Conclusion. It was observed that, in the patients undergoing ERCP, administration of propofol in combination with an opioid provided effective and reliable sedation, reduced the total dose of propofol, increased the practitioner satisfaction, decreased the pain level, and provided hemodynamic stability compared to the administration of propofol alone.

Hormonal status of patients after surgical treatment of fibrocystic mastopathy and possibilityes of its corrections

2017 ◽  
pp. 128-131
Author(s):  
Yu.Ya. Pryshash ◽  
Keyword(s):  
Surgical Treatment ◽  
Standard Dose ◽  
Treatment Phase ◽  
Nodule Formation ◽  
Double Dose ◽  
Postoperative Rehabilitation ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
High Doses

The purpose of the study was to investigate the efficacy of Mastodynon in terms of indications in elevated doses versus the standard dose. Materials and methods. Data were analyzed for 60 patients after surgical treatment of fibro-cystic mastopathy. Depending on the postoperative therapy received by the patients, they were divided into three groups. Group I (n = 20): patients were observed in accordance with the standards established in mammal practice and did not receive special agents that affect hormonal homeostasis. Group II (n = 20): In addition to observation, patients received Mastodynon® (1 tablet or 30 drops 2 times a day) for 6 months. Group III (n = 20): Patients were given for a post-operative rehabilitation Mastodynon® in a double dose (2 tablets or 60 drops 2 times a day) for 6 months. Results Surgical treatment without conservative therapy eliminates organic changes in the thoracic glands (GH), but hormonal disorders that have led to pathologic and histological changes in the tissues of GZ continue to exist for a long time and can lead to repeated nodal formations. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. In group І, 25% of patients within 2 years performed repeated sectoral resections on recurrence of nodule formation. The use of Mastodynon® in standard doses (group II) for postoperative rehabilitation contributes to a significant improvement in hormonal homeostasis (normalization of prolactin, estradiol and progesterone levels), a 24.7 mm decrease in the degree of cyclic mastodynia according to the visual analog scale (VAS), and the improvement of ultrasound scan Pictures of GZ in 75% of patients. The most pronounced effect of this rehabilitation approach after the surgical treatment phase was noted for the use of Mastodynone in doble doses (2 tablets or 60 drops 2 times a day) in Group III. In these patients, the degree of reduction of cyclic mastodynia was 30 mm for VAS and positive changes in the tissues of GH were noted in 85% of patients. However, the highest incidence of adverse events was also noted in Group III, although they were temporary in nature and did not require withdrawal or dose reduction. Conclusion. Despite the presence of short-term side effects and rapid rebounding in the double-dose Mastodynon® group, our study showed better results than standard doses, faster and more stable therapeutic effect. Taking into account the results obtained, it can be argued that the use of high doses of Mastodynon® may be recommended to patients for the treatment of mastopathy. For a more complete study of such an important aspect as the tolerability of high doses of Mastodynon®, it is advisable to conduct more extensive studies, taking into account the dosage form and the use of other drugs. Key words: mastopathy, postoperative rehabilitation, Mastodynon®, mastodynia.

scholarly journals Influence of non-steroidal anti-inflammatory drugs on the inflammatory sonographic features in erosive hand osteoarthritis: an intervention study

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Qun Xia Xu ◽  
Ruth Wittoek
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Randomized Study ◽  
Power Doppler ◽  
Doppler Signal ◽  
Control Group ◽  
Hand Osteoarthritis ◽  
Synovial Proliferation ◽  
Numerical Rating ◽  
Power Doppler Signal

Abstract Objective The aim was to examine whether inflammatory US features in erosive hand OA patients change when discontinuing intake of NSAIDs before US examination in a non-randomized study. Methods Patients (n = 99) were allocated to the NSAIDs or control group according to their intake at baseline. US was performed at baseline (T0) and 2 weeks after discontinuation of NSAIDs (T1). Inflammatory features (i.e. synovial proliferation, effusion and power Doppler signal) were scored using a semi-quantitative scale (from zero to three). Pain levels were scored on a numerical rating scale. Binomial mixed models were fitted for US features, and odds ratios of having a US score of at least two vs at most one for synovial proliferation and effusion, and zero vs at least one for power Doppler were calculated. Results At baseline, both groups [NSAIDs group (n = 47) vs control group (n = 52)] were comparable for numerical rating scale pain, disease duration, number of radiographically affected joints, BMI and US baseline data, but not for age (P = 0.005). At T1, more synovial proliferation and power Doppler signal was seen compared with T0 in the NSAIDs group (P = 0.018 and 0.031, respectively). However, the interaction term time*NSAIDs was not found to be significant for any variable. The numerical rating scale pain at T1 was higher compared with baseline, although statistically non-significant. Conclusion No significant changes in inflammatory US features were seen in patients with erosive hand OA after withdrawal of NSAIDs for 2 weeks. This study suggests that an NSAID-free period is not necessary before assessing inflammatory disease activity in erosive hand OA.

Listening to Music during Outpatient Cystoscopy Reduces Pain and Anxiety and Increases Satisfaction: Results from a Prospective Randomized Study

2021 ◽  
pp. 1-7
Author(s):  
Jan-Niclas Mumm ◽  
Lennert Eismann ◽  
Severin Rodler ◽  
Theresa Vilsmaier ◽  
Alaleh Zati Zehni ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Pain Score ◽  
Classical Music ◽  
Randomized Study ◽  
Rank Correlation ◽  
Control Group ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Satisfaction Rates

<b><i>Background:</i></b> This study investigates the effect of classical music, music of patients’ own choice, or no music on pain reduction during elective cystoscopy. <b><i>Objectives:</i></b> The aim of the study was to describe the effect of listening to classical music, music of patients’ own choice, or no music on patient’s pain and satisfaction rates when carrying out an elective cystoscopy and the effect on the assessment capability of the performing urologist. <b><i>Design, Setting, and Participants:</i></b> This randomized trial included 127 patients undergoing elective cystoscopy at the Urological Department of the University Clinic of Munich between June 2019 and March 2020. <b><i>Outcome Measurements and Statistical Analysis:</i></b> Patients were assigned randomly to 3 groups: group I: listening to standardized classical music (<i>n</i> = 35), group II: listening to music according to the patients’ choice (<i>n</i> = 34), and control group III: no music (<i>n</i> = 44). Prior to cystoscopy, anxiety levels were assessed by the Beck Anxiety Inventory (BAI). The Visual Analog Scale (VAS, range 1–100) was used for a self-assessment of pain, discomfort, and satisfaction. Statistical analysis was done with Spearman’s rank correlation and <i>t</i>-tests. <b><i>Results and Limitations:</i></b> The median age was 63 (range 27–91) years. The duration of cystoscopy was 5.7 (1–30) min. Patients had undergone a median of 2.3 cystoscopies in the past. Between giving informed consent and cystoscopy, patients had to wait for a median of 64 (0–260) min. The median VAS pain score was significantly lower in group I at 1.7 and group II at 2.3 versus 5.2 in the control group III (<i>p</i> &#x3c; 0.001). The control group III had significantly worse pain and patient satisfaction rates compared with groups I and II. Group I had a significant lower VAS pain score than groups II and III (<i>p</i> &#x3c; 0.001). Classical music also increased the assessment capability of the preforming urologist. <b><i>Conclusions:</i></b> Listening to music during elective cystoscopy significantly reduces pain and distress and leads to higher patient and surgeon satisfaction. We recommend listening to classical music or music chosen by the patients during outpatient flexible/rigid cystoscopy in daily clinical routine. <b><i>Patient Summary:</i></b> In this study, we found that patients who listened to classical music or music of their own choice while undergoing a cystoscopy showed significant reduction of pain and distress.

scholarly journals Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

2021 ◽  
pp. 1-6
Author(s):  
Mohamed G. Soliman ◽  
Osama El-Gamal ◽  
Samir El-Gamal ◽  
Ali Abdel Raheem ◽  
Ahmed Abou-Ramadan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Study Groups ◽  
Controlled Study ◽  
Expulsion Rate ◽  
Medical Expulsive Therapy ◽  
Group Iii ◽  
Group I ◽  
Younger Age ◽  
Significant Difference ◽  
Group Ii

<b><i>Aim:</i></b> To compare the efficacy and safety of silodosin versus tamsulosin as medical expulsive therapy for stones of lower-third ureter in children. <b><i>Patients and Methods:</i></b> This prospective single-blind placebo-controlled randomized study included 167 pediatric patients who presented with distal ureteric stone (DUS) less than 1 cm. Patients were randomized into 3 groups; group I received silodosin 4 mg once daily, and group II received tamsulosin 0.4 mg while those in group III had placebo. The side effects of the used drugs, both rate and time of stone expulsion, and number of pain episodes were compared among the study groups for a maximum of 4 weeks. <b><i>Results:</i></b> Follow-up data of our patients after treatment revealed that the stone expulsion rate was significantly higher and the time to stone expulsion was significantly shorter in group I (89.3%, 12.4 ± 2.3 days) and group II (74.5%, 16.2 ± 4.2 days) compared to group III (51.8%, 21.2 ± 5.6). However, a statistically significant difference between silodosin and tamsulosin groups in favor of the former one was reported regarding the 2 studied items. Meanwhile, pain episodes requiring analgesia were statistically fewer in group I and II in contrast to placebo group. Adverse events were comparable among all groups. <b><i>Conclusion:</i></b> Silodosin provides significantly better stone expulsion rate and shorter expulsion time than tamsulosin for treatment of DUS. Both medications showed good safety profiles in children. However, further studies are required on a larger scale to confirm our results. Assessment of drug safety on younger age-group is still needed.

scholarly journals Study on Efficacy of Nalbuphine Hydrochloride as Pre-Emptive Analgesic – Comparison With Diclofenac Sodium after Open Cholecystectomy

2009 ◽  
Vol 20 (2) ◽  
pp. 39-44
Author(s):  
Md Quamrul Islam ◽  
Hasina Begum ◽  
AKM Akhtaruzzaman ◽  
UH Shahera Khatun
Keyword(s):  
Muscle Relaxation ◽  
Open Cholecystectomy ◽  
Diclofenac Sodium ◽  
Randomized Study ◽  
Afferent Input ◽  
P Value ◽  
Group Iii ◽  
Central Processing ◽  
Group I ◽  
Group Ii

Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The aim of this study was to evaluate the effects of preemptively used nalbuphine and diclofenac on postoperative pain and opioid consumption. Seventy five patients scheduled for open cholecystectomy were investigated by randomized study. Patients were divided into three groups. In group I, patients received Inj. Nalbuphine Hydrochloride (0.3 mg/kg bw IV) before induction. In group II, patients received Inj. Diclofenac Sodium (1 mg/kg bw IV) before induction and in group III patients received placebo before induction. General Anesthesia was given in all groups with Inj. Thiopental sodium 5mg/kg and Inj. Succninylcholine 1.5mg/kg to facilitate endotracheal intubation. Anesthesia was maintained with halothane 0.5% and nitrous oxide 66% in oxygen. Muscle relaxation was maintained by Inj.Vecuronium 0.1 mg/kg. Intraoperative proper hydration was maintained by lactate ringer's solution.In post operative period patients in all three groups received Inj. Pethidine 10mg IV till the patients got relieved from pain. The minimum interval of giving pethidine was 10 minutes. Through our study we have found that, pethidine consumption in 24 hours in group-I (Nalbuphine group) was 54.00±1.0, in group-II (Diclofenac group) was 74.00±1.0 and in group-III (Placebo group) was 112.0±2.0 and p-value <0.001, which is highly significant (measured in mg). Time of first pethidine demand in group-I was 45.83±10.93, in group-II was 34.20±5.44and in group-III was 16.21±3.62 and p-value<0.001 which is also highly significant (measured in minute). Overall patients satisfaction was high in nalbuphine group. Under the condition of present study, we can conclude that preemptively used nalbuphine hydrochloride decreases post operative pain and opioid demand. Journal of BSA, Vol. 20, No. 2, July 2007 p.39-44

scholarly journals Effect of hyaluronate and splinting alone versus combined treatment (splinting and hyaluronate) on thumb carpometacarpal osteoarthritis

2020 ◽  
Vol 2 (1) ◽  
pp. 35-40
Author(s):  
Salvatore Denaro ◽  
Salvatore Boccaccio ◽  
Antonino Zocco
Keyword(s):  
Grip Strength ◽  
Rating Scale ◽  
Combined Treatment ◽  
Numeric Rating Scale ◽  
Group Iii ◽  
Pain Disability ◽  
Group I ◽  
Group Ii ◽  
Thumb Carpometacarpal ◽  
Carpometacarpal Osteoarthritis

Thumb carpometacarpal osteoarthritis can lead to global hand dysfunctions and its symptoms are pain and inability. The purpose of this study is to determine the effectiveness of hyaluronate in relieving these symptoms, and to compare it to orthosis and combined treatment (orthosis and hyaluronate). We enrolled 39 patients, evaluated at the baseline by using numeric rating scale (NRS) for pain, Disability of the Arm, Shoulder and Hand (DASH) and Dreiser Scale for disability degree, and Digital Hydraulic Pinch Gauge for grip strength. Eligible participants were randomly assigned to one of the three treatments: injection of hyaluronate (group I), combined treatment (hyaluronate and orthosis, Group II) and orthosis (hard-resting splint, Group III). Patients of Group I and Group II were injected by low molecular weight Hyaluronate once a week for three consecutive weeks. Injections were performed by means of the so-called blind technique. The data analysis indicated a significant decrease (P<0.01) of pain at week 4, further manifested at week 26 by all groups treated. The same occurred for functional symptoms, and grip strength. This improvement appears more evident in group I that received HA.

scholarly journals Local Bupivacaine Infiltration to Reduce Pain after Tonsillectomy: A Low Cost Approach

2021 ◽  
Vol 28 (3) ◽  
pp. 228-233
Author(s):  
Rakesh B S ◽  
Bharathi M B ◽  
Thanzeemunisa U ◽  
Kumar Shankar De ◽  
Nitish Aggarwal
Keyword(s):  
Rating Scale ◽  
Low Cost ◽  
Major Drawback ◽  
Group Iii ◽  
Pain Scores ◽  
Group I ◽  
Significant Difference ◽  
Average Pain ◽  
Group Ii ◽  
Double Blinded

Introduction Tonsillectomy is one of the most commonly performed surgical procedures worldwide, with the major drawback of significant post operative pain.There is no consensus regarding topical application or local infiltration of anesthetics post operatively to reduce pain. The present study was performed to evaluate the effect of bupivacaine infiltration in the tonsillar fossae after tonsillectomy. Materials and Methods A double-blinded clinical trial was performed on 75 patients undergoing tonsillectomy between January 2019 and January 2020. All patients underwent tonsillectomy under general anesthesia and were then randomly divided into 3 groups of 25 patients each. For Group I, a swab soaked in normal saline was applied to the tonsillar fossae for 5 minutes just before extubation. In Group II, a swab soaked in 5 ml of 0.5% bupivacaine was placed for 5 minutes, while in Group III, 5ml of 0.5% bupivacaine was infiltrated in the tonsillar fossae. The intensity of pain for each group was measured in the immediate post op period, at6 hours, 24 hours and 1 week by Wong Baker Faces Pain Rating Scale. Results There was a significant difference in the mean level of pain between groups I and III in the immediate post op period, at 6 hours and 24 hours. Although the average pain scores of group III were better than those of group II, the results were significant only in the 6 hour post op period. Conclusion To reduce post-tonsillectomy pain,0.5% bupivacaine can be infiltrated into the tonsillar fossa.

scholarly journals Midazolam and Thiopentone as Co-Induction

2009 ◽  
pp. 23-27
Author(s):  
Md Habibur Rahman ◽  
Mahbub Hassan ◽  
Md Monirul Islam
Keyword(s):  
Blood Pressure ◽  
Induction Time ◽  
Randomized Study ◽  
Induction Agent ◽  
Double Blind ◽  
Group Iii ◽  
Midazolam Group ◽  
Thiopentone Sodium ◽  
Group I ◽  
Group Ii

This study was undertaken to compare the induction characteristics of conventional thiopentone sodium, midazolam, and a combination of midazolam and thiopentone sodium as co-induction agent. Total one hundred and fifty patients of ASA grade I and II were divided into three groups in a double blind randomized study. Group-I received midazolam 0.25 mgkg-1 intravenously, group-II received thiopentone sodium 5 mgkg-1 intravenously and Group-III received midazolam 0.1 mg/kg-1 IV followed by thiopentone sodium 2.5 mg/kg-1 IV. Induction time was significantly prolonged with midazolam (group-II) compared to thiopentone sodium. The fall in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was clinically insignificant in midazolam group. Induction with midazolam was not smooth and was associated with unwanted movement of limbs. Incidence of apnoea, pain, thrombophlebites were significantly less with midazolam. Co-induction with midazolam and thiopentone significantly reduced the induction time, unwanted movements of limbs, apnoea during induction and cardiovascular stability was also more in co-induction group than thiopenfone sodium group. Incidence and duration of drowsiness was also significantly lesser in coinduction group. These advantages signifies that combination of midazolan and thiopentone is better choice for induction of anaesthesia than the other conventional induction agent like individual midazolam or thiopentone.DOI: http://dx.doi.org/10.3329/jbsa.v17i1.4047 Journal of BSA, Vol. 17, No. 1 & 2, 2004 p.23-27

scholarly journals Conservative Treatment for Plantar Fasciitis

2018 ◽  
Vol 3 (2) ◽  
pp. 2473011418S0000
Author(s):  
Carlos Jasmin Alfredo Lobo
Keyword(s):  
Plantar Fasciitis ◽  
Diclofenac Sodium ◽  
Randomized Study ◽  
Local Infiltration ◽  
Group Iii ◽  
Muscle Stretching ◽  
Group I ◽  
Evaluation Group ◽  
Group Ii ◽  
Night Splints

Category: Hindfoot Introduction/Purpose: The objective of this study was to compare the results obtained in the treatment of plantar fasciitis, by: group I, muscle stretching (plantar and gastrocnemius); Group II, use of the dorsiflexion night splints; and group III, permanent elevation use of shoe heel, 2 cm or more, in relation to forefoot. Methods: One hundred and fifty patients participated in the prospective and randomized study. After randomizing the method, the patients received treatment orientation. Prescription: 150 mg diclofenac sodium, single daily dose, for 7 days. Group II, they underwent daily physiotherapy with plantar stretching and electrotherapy, associated to the use of the night splints. The evaluations were at 30 and 60 days. In the first evaluation, eight patients underwent local infiltration of betamethasone dipropionate, betamethasone disodium phosphate: five from Group I and three from Group II. All patients were evaluated on the AOFAS score of the hindfoot. Results: First evaluation: group I, 52% showed little improvement (AOFAS: initial 53.5, 30 days 56.6); Group II, 38% were dissatisfied and uncomfortable with the night splints (AOFAS: initial 55.6, 30 days 63.3). In group III, 22% of the patients reported pain arising in the morning and after periods of sitting (AOFAS: initial 57.7, 30 days 81.6). Second evaluation: Group I, AOFAS 56.9; Group II AOFAS 72.2; group III AOFAS 88.6. Conclusion: heel elevation presented a satisfactory result, superior to the other methods used; difficulty for patient’s adhesion because it eliminates usage of shoes with no heels; AOFAS / scale close to all patients treated.

Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

1970 ◽  
Vol 28 ◽  
pp. 208-209
Author(s):  
K.K. SEKHRI ◽  
C.S. ALEXANDER ◽  
H.T. NAGASAWA
Keyword(s):  
Osmium Tetroxide ◽  
Male Mice ◽  
Alcohol Group ◽  
Group Iii ◽  
Group I ◽  
C57bl Mice ◽  
Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

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