scholarly journals A Comparative Study of 0.25% Levobupivacaine, 0.25% Ropivacaine, and 0.25% Bupivacaine in Paediatric Single Shot Caudal Block

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Jagdeep Sharma ◽  
Ruchi Gupta ◽  
Anita Kumari ◽  
Lakshmi Mahajan ◽  
Jasveer Singh
Keyword(s):  
Postoperative Pain ◽  
Demographic Data ◽  
Single Shot ◽  
Haemodynamic Parameter ◽  
Paediatric Patients ◽  
Parametric Data ◽  
Intergroup Comparison ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. There are limited data comparing levobupivacaine, ropivacaine, and bupivacaine in paediatric patients. So, this study was performed to evaluate the caudal effectiveness of all the three drugs in paediatric patients undergoing infraumbilical surgeries and associated complications with these drugs. Material and Methods. 90 patients of ASA grade I and II posted for elective infraumbilical surgeries were randomly divided into three groups of 30 each. A standardized anaesthetic protocol was used. Patients received 0.25% levobupivacaine in group 1, 0.25% ropivacaine in group 2, and 0.25% bupivacaine in group 3. The effectiveness of block was assessed using caudal effectiveness score. Postoperative pain relief was assessed with modified Hannallah pain score. Haemodynamic parameter monitoring was done. The duration of analgesia and associated complications were studied. Statistical analysis was done using the chi-square test for nonparametric data. Parametric data were analysed using ANOVA for intergroup comparison and Tukey’s HSD for intragroup comparison. Results. Demographic data were comparable. Haemodynamic parameters remained within normal range. Mean caudal effectiveness score in all the three groups was statistically insignificant (p>0.05). The duration of analgesia provided by bupivacaine (145.31 ± 26.17 min) was longer than levobupivacaine (126.15 ± 15.15 min) and ropivacaine (114.68 ± 11.32 min) (p<0.01). Mean postoperative pain scores were lower in group 3 as compared to group 1 and group 2. Conclusion. We conclude that levobupivacaine and ropivacaine provide similar intraoperative quality with minimal haemodynamic variability and shorter duration of postoperative analgesia without any significant complications when compared with racemic bupivacaine. This trial is registered with CTRI/2018/03/012402.

scholarly journals An In Vivo Confocal Microscopic Study of Corneal Nerve Morphology in Unilateral Keratoconus

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Natasha Kishore Pahuja ◽  
Rohit Shetty ◽  
Rudy M. M. A. Nuijts ◽  
Aarti Agrawal ◽  
Arkasubhra Ghosh ◽  
...  
Keyword(s):  
Nerve Fiber ◽  
Nerve Branch ◽  
Intergroup Comparison ◽  
Corneal Nerve ◽  
Group 3 ◽  
Group 2 ◽  
Branch Density ◽  
Corneal Nerve Morphology ◽  
Group 1

Purpose.To study the corneal nerve morphology and its importance in unilateral keratoconus.Materials and Methods.In this prospective cross-sectional study, 33 eyes of 33 patients with keratoconus in one eye (Group 3) were compared with the other normal eye of the same patients (Group 2) and 30 eyes of healthy patients (Group 1). All patients underwent detailed ophthalmic examination followed by topography with Pentacam HR and in vivo confocal microscopy (IVCM). Five images obtained with IVCM were analyzed using an automated CCmetrics software version 1.0 for changes in subbasal plexus of nerves.Results.Intergroup comparison showed statistically significant reduction in corneal nerve fiber density (CNFD) and length (CNFL) in Group 3 as compared to Group 1 (p<0.001andp=0.001, resp.) and Group 2 (p=0.01andp=0.02, resp.). Though corneal nerve fiber length, diameter, area, width, corneal nerve branch density, and corneal total branch density were found to be higher in decentered cones, only the corneal nerve branch density (CNBD) was found to be statistically significant (p<0.01) as compared to centered cones.Conclusion.Quantitative changes in the corneal nerve morphology can be used as an imaging marker for the early diagnosis of keratoconus before the onset of refractive or topography changes.

Postoperative Pain Control with a New Transdermal Fentanyl Delivery System

1995 ◽  
Vol 83 (3) ◽  
pp. 470-477. ◽  
Author(s):  
Rafael Miguel ◽  
Joel M. Kreitzer ◽  
Douglas Reinhart ◽  
Peter S. Sebel ◽  
Julius Bowie ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Delivery System ◽  
Pain Control ◽  
Fentanyl Patch ◽  
Postoperative Pain Control ◽  
Transdermal Fentanyl ◽  
Placebo Patch ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background A new transdermal delivery system for fentanyl is available in two strengths: 70-80 and 90-100 micrograms.kg-1.h-1 (40- and 60-cm2 patches, respectively). Their short onset and 24-h drug delivery make them attractive for postoperative pain control. Methods Both doses of the new transdermal fentanyl patches were evaluated for the relief of postoperative pain in 143 patients after gynecologic exploratory laparotomy. The study was conducted at four centers using a prospective, randomized, placebo-controlled, double-blind format. Patients were randomly assigned to one of three study groups: group 1 patients received two placebo patches: group 2 patients received a 40-cm2 fentanyl patch and a 60-cm2 placebo patch; and group 3 patients received a 60-cm2 fentanyl patch and a 40-cm2 placebo patch. Patient-controlled morphine use and pain, sedation, and comfort scores were assessed postoperatively every 4 h for 36 h after patch placement. Results Patients' assessment of their analgesia was significantly (P &lt; or = 0.05) better in group 2 at 16 and 24 h and in group 3 at 8, 12, 16, 20, and 24 h postoperatively, compared with the patients in group 1. Patients in groups 2 and 3 required less supplemental morphine to maintain satisfactory analgesia than did the patients in group 1. Patients in groups 2 and 3 had greater incidences of pruritus, erythema, and respiratory depression than did those receiving placebo. Conclusions Concern exists regarding the side effects of this this new transdermal fentanyl patch. Therefore, this new patch will need further research before it can be recommended as an adjunct in controlling postoperative pain.

A Study of 65 Impotent Males

1975 ◽  
Vol 127 (4) ◽  
pp. 337-341 ◽  
Author(s):  
J. M. A. Ansari
Keyword(s):  
Marital Status ◽  
Demographic Data ◽  
Marital Relationships ◽  
Homogeneous Population ◽  
Duration Of Illness ◽  
Sex Drive ◽  
Erectile Impotence ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummarySixty-five patients primarily referred for erectile impotence were investigated. Information was obtained from patients and their partners. The demographic data are compared with those from a non-impotent psychiatric out-patient group, matched for age. Results indicate that impotent cases do not form a homogeneous population and can be classified into three fairly distinct groups. These groups differ in age, marital status, sex drive, pre-marital and post-marital relationships, duration of illness, etc. Group 1 develop impotence because of anxiety in sexual situations, Group 2 react to the sexual response and personality of their partners, while Group 3 decline, perhaps from inherent constitutional causes. Factors such as religious restrictions, sexual taboos, alcoholism and homosexuality do not appear to be of any aetiological importance.

scholarly journals EPIDURAL ANAESTHESIA

2010 ◽  
Vol 17 (02) ◽  
pp. 318-324
Author(s):  
AZMAT RIAZ ◽  
HAMID SAEED MALIK ◽  
BILAL YASIN
Keyword(s):  
Patient Satisfaction ◽  
Epidural Anaesthesia ◽  
Knee Arthroscopy ◽  
Single Shot ◽  
Care Hospital ◽  
Day Case ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives: To compare the benefits and adverse effects of three different drug combinations when used for single-shot epidural anaesthesia for day-case arthroscopy. Design of Study: Prospective, random, double-blind study. Setting: A 250 bedded secondary care hospital. Period: From October 2005 to Feb 2007. Material and Methods: We studied 75 adult male patients, aged between 23 to 63 years, weight <100 kg, ASA physical status I or II undergoing elective knee arthroscopy as day-case procedure. Patients were randomly divided into three groups ( 25 patients in each group) and single-shot epidural anaesthesia was performed using a total of 20 ml epidural lignocaine 2% (Group 1) bupivacaine 0.5% (Group 2) or a mixture containing lignocaine 2% and bupivacaine 0.5%, 10 ml each (Group 3). Results: Time to achieve maximum height (in minutes) was similar in group-1 and group-3 (10±4 and 11±2), but it was significantly longer in group-2 (20±3). Block time was comparable in group-2 and 3 (130±25 and 118±37) but it was significantly shorter in group-1 (60±20). Post-operative discharge time was longest in the group-2, and comparable in group-1 and 3.The incidence of complications like bradycardia, hypotension, nausea and vomiting were more in group-2 and less in group-1 and group-3. Inadequate anaesthesia was more in group-1 and least in other two groups.Four patients of group-1 needed rescue analgesia and two from same group needed general anaesthesia as compared to none in group-2 and group-3. In 4-point patient satisfaction scale, maximum patients from Group-3 rated it perfect while most patients from group-1 were not satisfied with the quality of anaesthesia. Conclusions: The results of our study show that a 50-50 mixture of lignocaine and bupivacaine withfentanyl 50 μg when used for single-shot epidural anaesthesia for day case knee arthroscopy, provides better quality of analgesia, with fewer incidences of side effects and more patient satisfaction as compared to lignocaine or bupivacaine alone.

Measurement of the Maximum Occlusal Bite Force and its Relation to the Caries Spectrum of First Permanent Molars in Early Permanent Dentition

2020 ◽  
Vol 44 (6) ◽  
pp. 423-428
Author(s):  
Ravi Kumar Gudipaneni ◽  
Mohammad Khursheed Alam ◽  
Santosh R Patil ◽  
Mohmed Isaqali Karobari
Keyword(s):  
Bite Force ◽  
Permanent Dentition ◽  
Cross Sectional ◽  
Intergroup Comparison ◽  
Permanent Molars ◽  
Group 3 ◽  
Group 2 ◽  
First Permanent Molars ◽  
Occlusal Bite Force ◽  
Group 1

Objective: To determine the maximum occlusal bite force (MOBF) of the complete spectrum of dental caries in first permanent molars (FPMs) in children aged 7–9 years. Study design: A cross-sectional study was conducted on 123 children. The evaluation of the caries spectrum of FPMs was carried out using the Caries Assessment Spectrum and Treatment index (CAST). The MOBF was measured in the FPM region using the portable occlusal force gauze. Independent sample t-test and one-way analysis of variance test were performed to compare MOBF with CAST scores of FPMs. Based on the CAST scores, FPMs were categorized into three groups, group 1: healthy (score 0, 1, 2), group 2: premorbid (score 3), group 3: morbid (score 4, 5). Results: A significantly lower MOBF was observed (167.56 N ± 49.77) in the morbid stage (group 3) than in the premorbid stage (group 2: 291.57 N ± 56.64), and healthy (group 1; 320.93 N ± 54.23). Intergroup comparison also revealed that FPMs in the healthy stage was associated with a higher bite force compared to those in the premorbid and morbid stages (p&lt;0.001). Conclusions: The mean MOBF decreased with the progression of the caries spectrum of FPMs in early permanent dentition.

scholarly journals Posttreatment and physiologic occlusal changes comparison

2012 ◽  
Vol 83 (2) ◽  
pp. 239-245 ◽  
Author(s):  
Karina Maria S. Freitas ◽  
Guilherme Janson ◽  
Bryan Tompson ◽  
Marcos Roberto de Freitas ◽  
Tassiana Mesquita Simão ◽  
...  
Keyword(s):  
Peer Assessment ◽  
Untreated Group ◽  
Anterior Crowding ◽  
Irregularity Index ◽  
Intergroup Comparison ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Observation Period ◽  
Group 1

ABSTRACT Objective: To compare posttreatment and postretention occlusal changes with the physiologic occlusal changes caused by natural development of untreated subjects. Materials and Methods: The sample was divided into three groups. Group 1 comprised 97 subjects treated with four premolar extractions at a mean pretreatment (T0) age of 13.03 years, a mean posttreatment (T1, first observation) age of 15.12 years, and a mean postretention (T2, second observation) age of 20.52 years. The mean observation period (T2-T1) was 5.39 years. Group 2 comprised 58 subjects treated nonextraction at a mean pretreatment age of 12.83 years, a mean posttreatment age of 14.99 years, a mean postretention age of 20.22 years, and a mean observation period of 5.22 years. Group 3 comprised 114 untreated subjects at a mean age at T1 of 14.91 years and at T2 of 20.48 years. The mean observation period was 5.56 years. Dental casts were evaluated using the Peer Assessment Rating (PAR) index and the Little irregularity index in maxillary and mandibular arches. Changes in PAR and Little indexes were compared among the three groups by analysis of variance and Tukey tests. Results: Intergroup comparison showed that at T1 and T2 the treated groups presented smaller PAR and Little indexes than the untreated group. In the observation period, the treated groups showed greater increase in PAR and Little maxillary indexes than the untreated group. The extraction group showed a greater increase of the Little mandibular index than the untreated group. Conclusions: The treated groups showed more changes according to PAR and Little maxillary indexes than the untreated group. The posttreatment change of the mandibular anterior crowding of the treated extraction group was greater than the mandibular crowding caused by physiologic changes in the untreated group.

scholarly journals TOOTH BRUSHING TECHNIQUES

2018 ◽  
Vol 25 (01) ◽  
pp. 135-139
Author(s):  
Muhammad Ilyas ◽  
Sobia Ashraf ◽  
Hamza Jamil
Keyword(s):  
Random Selection ◽  
Plaque Index ◽  
Plaque Score ◽  
Intergroup Comparison ◽  
Group 3 ◽  
Group 2 ◽  
Method Group ◽  
Group 1 ◽  
Data Result

Objective: This study is performed to ascertain the efficacy of “horizontal scrub”Fones method and “modified bass” brushing techniques. Method: A group of 150 schoolchildren of age 8-11 years were randomly selected in different schools of Gojra city. Threegroups of schoolchildren were made by random selection and children of each group weredemonstrated by one of the three techniques. Group 1(Fones method). Group 2(modifiedBass). Group 3(Horizontal scrub). All the kids under this study were reexamined after two daysand re-assess the plaque index and to obtain follow-up data. Result: The result concluded bystatistical analysis and intergroup comparison also concluded by using ANOVA test. Reductionin plaque score was assessed and compared with each other. Conclusion: Modified Bass wasfound most effective in the reduction of plaque score, horizontal scrub was the second effectivetechnique and least one was Fones.

scholarly journals The Efficacy of Little Lovely Dentist, Dental Song, and Tell-Show-Do Techniques in Alleviating Dental Anxiety in Paediatric Patients: A Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hira Abbasi ◽  
Muhammad Saqib ◽  
Rizwan Jouhar ◽  
Abhishek Lal ◽  
Naseer Ahmed ◽  
...  
Keyword(s):  
Heart Rate ◽  
Dental Anxiety ◽  
Facial Image ◽  
Paediatric Patients ◽  
Scale Scores ◽  
Group 3 ◽  
Anxiety Levels ◽  
Group 2 ◽  
Facial Image Scale ◽  
Group 1

Introduction. Dental anxiety is a common occurrence in patients undergoing dental treatments, especially in children. The success in paedriatric dental treatments and patient comfort depends on controlling the level of patient’s anxiety in clinical settings. This study is aimed at evaluating the efficacy of different techniques applied for the reduction of dental anxiety in paediatric patients. Material and Methods. One hundred and sixty participants were divided into 4 groups; each group having 40 patients as follows: group I: mobile application “little lovely dentist,” group II: YouTube® “dental video songs,” group III “tell-show-do,” and group IV “control.” Dental prophylaxis treatments were provided to all the participants. Initial anxiety levels were noted during the patient’s education phase by measuring heart rate with pulse oximeter and distress level with facial image scale, at the same time in each group, respectively. The postoperative anxiety was noted later with the same methods, after the application of anxiety reduction techniques. The data obtained were entered in the statistical package for the social sciences software, version 25. One-way ANOVA and paired t -test for matched groups were used to compare mean values of the 4 groups, in this study to determine their effectiveness. A p value of ≤0.05 was considered as statistically significant. Results. The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group. Conclusion. The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, “little lovely dentist,” and “dental songs” can alleviate dental anxiety experienced by paediatric patients. The “tell-show-do” technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.

scholarly journals Renal bone disease in patients on hemodialysis: an observational study focusing on the variation of calcium metabolism

2019 ◽  
Vol 7 (7) ◽  
pp. 2660
Author(s):  
Wajeeha Elahi ◽  
Ameen Zubair Syed ◽  
Bilal Jamil ◽  
Shahid Kamran ◽  
Raheela Adil ◽  
...  
Keyword(s):  
Demographic Data ◽  
The Body ◽  
Cross Sectional ◽  
Related Data ◽  
Significant Difference ◽  
Renal Bone Disease ◽  
Group 3 ◽  
Group 2 ◽  
Pth Level ◽  
Group 1

Background: The aim of this study was to determine the disturbances in the levels of mineral in the body due to hemodialysis at different levels of parathormone levels and to assess its association with the calcium levels.Methods: Study was a cross sectional for the period of 6 months taking ethical approval. Total 255 cases were registered in this study after taking their informed consent. The cases were divided into three groups according to PTH level. Group 1 has 87 subjects with PTH level <250, group 2 has 102 subjects with PTH level 250-650 and group 3 has 66 cases with PTH level >650. The cases were taking hemodialysis for greater than 6 months and have the ages more than 18 years were included in this study. The demographic data includes age, sex dialysis related data like duration of hemodialysis, levels of calcium, phosphorus, albumin, PTH, ALP were observed.Results: Hemodialysis duration were recorded in respective three groups as 7.28±5.71, 6.26±5.56 and 6.15±4.30 days respectively  (P=0.319). Calcium was found in group 1, 8.70±0.81, in group 2, 8.39±0.89 and in group 3, 8.76±0.82 (P=0.01). PTH level in three respective group were recorded to be 123.46±74.15, 418.47±115.49 and 1314.67±1188.63 (P <0.001).Conclusions: Present study showed that significant difference was found in mineral levels in patients on hemodialysis with PTH level as well as with alkaline phosphatase level. Nevertheless, no significant difference was found with duration of dialysis and with parameter of albumin.

The effect of tramadol or clonidine added to intraperitoneal bupivacaine on postoperative pain in total abdominal hysterectomy

2005 ◽  
Vol 1 (2) ◽  
pp. 77 ◽  
Author(s):  
Dilek Memis, MD ◽  
Alparslan Turan, MD ◽  
Beyhan Karamanlioglu, MD ◽  
Baris Tükenmez, MD ◽  
Zafer Pamukçu, MD
Keyword(s):  
Postoperative Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Early Postoperative Period ◽  
Peripheral Oxygen Saturation ◽  
Analgesic Requirement ◽  
Vas Scores ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Recent studies suggest that intraperitoneal application of local anesthetics is useful in abdominal surgery. Tramadol and clonidine have specific effects on peripheral nerves when used alone. We aimed to evaluate the effects of intraperitoneal application of bupivacaine and the combinations of bupivacaine plus tramadol and bupivacaine plus clonidine on postoperative pain in total abdominal hysterectomy.After standard anesthetic procedure during closure of the abdomen, Group 1 (n = 20) was given 20 mL bupivacaine 0.5 percent, Group 2 (n = 20) was given 20 mL bupivacaine 0.5 percent plus 100 mg tramadol, and Group 3 (n = 20) was given 20 mL bupivacaine 0.5 percent plus 1 μg per kg clonidine, all into the peritoneal cavity. Postoperative pain was evaluated with the visual analog scale (VAS) at 30 minutes, and two, four, six, 12, and 24 hours after extubation. While patients were supine and seated, mean arterial pressure (MAP), heart rate (HR), and peripheral oxygen saturation (SpO2) values were noted. When VAS scores were 4 to 7, 0.5 mg per kg of meperidine was given intramuscularly (IM); above 7, 1 mg per kg of meperidine was given IM; and when VAS scores were 2 to 4, 500 mg acetaminophen was given orally. For evaluating quality of analgesia, rescue analgesic dose, analgesia time, and side effects were noted.The groups were similar in respect to SpO2; however, when Group 1 was compared to Groups 2 and 3 at 30 minutes, and two, four, and six hours, MAP and HR measurements were found to be significantly higher (p < 0.05). VAS values in sitting and supine positions at 30 minutes and two hours were significantly lower in Group 2 (p < 0.05) when compared to Group 1. VAS values for Group 3 at 30 minutes, and two and four hours in the supine position, and at 30 minutes and two hours in the sitting position, were found to be significantly lower than those in Group 1 (p < 0.05). There were no significant differences between Groups 2 and 3.The mean dosage of meperidine used was 76.7 ± 10.5 mg in Group 1, 63.9 ± 8.4 mg in Group 2, and 70 ± 5.2 mg in Group 3. When Group 1 was compared to Group 2, there were significant differences found (p < 0.05). First analgesic requirement time was found to be 30 (range, 30 to 30) minutes in Group 1, 120 (range, 30 to 240) minutes in Group 2, and 110 (range, 30 to 240) minutes in Group 3. There were significant differences found when Groups 2 and 3 were compared to Group 1 (p < 0.05).We concluded that the combinations of bupivacaine plus tramadol and bupivacaine plus clonidine administered intraperitoneally in total abdominal hysterectomy operations provide more effective analgesia than bupivacaine alone during the early postoperative period.

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