scholarly journals Evaluation of Post-Operative Analgesia Using Clonidine as an Adjuvant with Caudal Bupivacaine in Paediatric Patients Posted for Infraumbilical Surgery

2021 ◽  
Vol 10 (35) ◽  
pp. 3005-3011
Author(s):  
Sinjini Agarwal ◽  
Neeta Chaudhari Verma ◽  
Amol P.S. ◽  
Pyarelal Pyarelal ◽  
Suzanna Elsa Varghese ◽  
...  
Keyword(s):  
Normal Saline ◽  
Ethical Review ◽  
Control Group ◽  
P Value ◽  
Paediatric Surgery ◽  
Rescue Analgesia ◽  
Significant Group ◽  
Number Of Patients ◽  
Group B ◽  
Caudal Epidural

BACKGROUND Caudal epidural block is a highly popular method of administering analgesia to children undergoing infraumbilical surgeries. Addition of clonidine, a centrally acting alpha 2 agonist as an adjuvant to caudal bupivacaine has added advantages of providing prolonged post-operative analgesia and also, thus reducing the number of doses of post-operative rescue analgesics. In this study, we wanted to compare the efficacy and safety of caudally administered clonidine as an adjuvant to bupivacaine. METHODS This was a prospective, comparative interventional study and was conducted in the Department of Anaesthesia at JNMC, Sawangi (Meghe) Wardha in accordance with the guidelines and permission of the institutional ethical review board. The study was carried out with 40 patients in each group randomly allocated using computer generated software, posted for infraumbilical surgeries between the age group 2 years to 7 years, American Society of Anaesthesiologists (ASA) grade I and II. Group B (control group) – Caudal epidural with 0.25 % bupivacaine 1 ml/kg + 1 ml normal saline. Group C (study group)- Caudal epidural with 0.25 % bupivacaine 1 ml/kg with clonidine 1 microgram/kg + 1 ml normal saline. RESULTS In our study, the mean duration of analgesia i.e. mean time for requirement of first rescue analgesia in group C was 9.9 ± 1.4 hours as compared to 4.7 ± 1.4 hours in group B (P < 0.0001). In this study, we used FLACC (face, legs, activity, cry, consolability) pain scale with its 0 - 10 score range for assessing the pain intensity. At FLACC pain score 4 or more, first dose of rescue analgesic was given. This score was reached at 8.8 hours in Group C (mean FLACC score at 3.8 ± 0.7) and 3.6 hours in Group B (mean FLACC score 3.4 ± 0.9) with P value (= 0.014) (significant). Group C required significantly lesser number of rescue analgesics in comparison to Group B. The number of doses of rescue analgesics required in the Group B were definitely more than that in Group C wherein 62.5 % required 3 doses and 25 % required 4 doses of rescue analgesics. On the other hand, in Group C the number of patients requiring more than 2 doses of rescue analgesia was 0 % thus proving the efficacy of clonidine in prolonging post-operative analgesia. CONCLUSIONS We concluded that caudally administered clonidine, in a dose of 1 microgram/kg as an adjuvant to 0.25 % bupivacaine 1 ml/kg, proved to be efficacious in providing prolonged analgesia both intraoperatively and post-operatively. Also, we observed that this addition, reduced the requirement of post-operative rescue analgesia and its associated side effects. KEY WORDS Caudal Epidural, Infraumbilical Paediatric Surgery, Clonidine, Bupivacaine, Postoperative Analgesia

scholarly journals Evaluation of the use of Hypertonic Saline 3% Nebulizer versus Intravenous Hypertonic Saline 3% to Attenuate the Manifestations of Acute Respiratory Distress Syndrome

2020 ◽  
Vol 14 (1) ◽  
pp. 52-61
Author(s):  
Amr Sobhy ◽  
Abdelkarem Hussiny ◽  
Mohammed Kamal
Keyword(s):  
Mortality Rate ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Distress Syndrome ◽  
Control Group ◽  
P Value ◽  
Icu Stay ◽  
Group A ◽  
Group B ◽  
Group D

Background: A well-known disease, Acute Respiratory Distress Syndrome (ARDS) presents a daunting challenge to the medical community with alarmingly high mortality rates. Initiation of hypertonic saline (HTS) nebulization therapy for patients with early ARDS appears to be tolerable and may be beneficial. However, using a nebulizer is cumbersome and less efficient. This study aims to assess the efficacy of using HTS3% in a nebulizer in comparison with intravenously injecting it to attenuate the manifestation of ARDS. The study analyses factors such as the severity of the disease, need and duration of mechanical ventilation (MV), ICU stay, and mortality rate in the comparative analysis. Materials and Methods: The randomized, comparative, and controlled study included patients of both genders from an age bracket of 18-60 years. The patients fulfilled the Berlin definition of ARDS. Additionally, the whole sample was divided into four groups (26 patients each): Group A received standard pharmacotherapy [methylprednisolone 1mg/kg/day intravenously and salbutamol nebulizer 2.5 mg (1 ml) + 3 ml normal saline/8hr] and normal saline 0.9% (5ml) nebulizer /8hr: Group B received standard pharmacotherapy + HTS2.7% (5ml) nebulizer/8hr: Group C also received standard pharmacotherapy and 500ml normal saline intravenously over 24 hours: Group D received standard pharmacotherapy and 500 ml HTS 3% intravenously over 24 hours. The following parameters were recorded: Lung injury score (Murray Score, calculated every 24 hours), the incidence of the need for MV, duration of MV, length of ICU stay, and mortality rate. Results: Group B (HTS nebulizer group) and group D (HTS IV group) showed the most rapid improvement in the Murray score with a 50% decrease in the score from its initial value (D50%) by day 4 with P-values of 0.013 and 0.022 respectively. Subjects from Group D (HTS IV) and Group B (HTS Nebulizer) were the least in need of MV as only 38.5% needed MV with a P-value <0.001. In comparison, 69.2% subjects from group A (control) and 73.1% from group C required MV, with a P-value <0.001. The shortest duration of MV care was found in group D (median 3.12 days), followed by group B (median 4.21 days). The results were highly significant, with P-value 0.004 when compared with group A (control group) and group C. In addition, the longest duration of MV care was reported in group A (median 5.37 days). There was significant variation in all groups regarding the length of ICU stay: group D required the least number of days (median 6.76 days), followed by group B (median 7.08 days). The result was statistically significant, with a P-value of 0.004 when compared with the control group (median 9.1 days) and group C(longest duration of MV with a median of 10.13 days). However, no significant difference was found in the mortality rate (P-value >0.05). Conclusion: The use of hypertonic saline 3% intravenously has a comparable effect as the use of hypertonic saline 3% via nebulizer to attenuate the manifestations of (ARDS) and even superior in the mechanically ventilated patient.

scholarly journals INTRATHECAL BETAMETHASONE;

2017 ◽  
Vol 24 (05) ◽  
pp. 733-738
Author(s):  
Hamid Raza ◽  
Bashir Ahmed ◽  
Kamlaish -
Keyword(s):  
Cesarean Section ◽  
Normal Saline ◽  
Random Number ◽  
Random Number Generator ◽  
Control Group ◽  
P Value ◽  
Number Generator ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Study Population

Objectives: The aim of our study to determine the use of intrathecal betamethasoneadministration as effective post-operative analgesic in gynecologic procedures. Study Design:Randomized control trial. Period: 6 months duration from April 2015 to end of September 2015.Setting: Tertiary Care Centre in Karachi, Pakistan. Method: The study population consisted ofn= 120 (divided into three groups using a random number generator) patients, who presentedto our setup either via emergency or through the outpatient. The patients belonged to ASAclass I and II, and underwent cesarean section. The group A was the control group, patientswho received 0.5ml normal saline IV with bupivacaine 0.5% in 3ml, with 0.5ml of normal salineintrathecally. Group B consisted of patients who received 0.5ml IV normal saline, with 0.5%in 3ml bupivacaine along with 0.5ml betamethasone as 4mg per ml. The last group, groupC consists of patients who received 0.5ml betamethasone IV (4ml/ml) along with 0.5% 3mlbupivacaine with 0.5ml of normal saline intrathecally. For the subjective measurement of painlevel a visual analog scale was used. Various time intervals as time of initial first analgesic effect,time between intrathecal injection and first administration of diclofenac as rescue analgesicand the total number of analgesics used in the first twenty four hour period were also recordedin the proforma. Various side effects such as nausea, vomiting and headache were noted.Data was analyzed using SPSS version 23. Results: The study population consisted of n=120 patients, divided into three groups using a random number generator, the demographicdata like age, whether the procedure performed was elective or emergency etc did not showany difference p value of >0.05. The Visual analog scales scores at the 4 hour and 6 hourmark showed statistically significant difference, the values being lower in the medication groupsversus the control group. But no difference was found between the control and medicationgroups in the VAS score measured at 12 hour and 24 hours respectively. The requirement foruse of Diclofenac as rescue analgesia was also lower in the intrathecal and intravenous (groupB and C) as compared to the control group at the 24 hour mark post operatively, and thedose required was even lower in the intrathecal group as compared to the intravenous grouphaving a p value of 0.014. N= 27 patients suffered nausea and vomiting during the procedure,N= 40 patients reported headache following the 24 hour period post operatively. Conclusion:According to the results of our study intrathecal betamethasone administration is an effectivemethod of post-operative pain reduction in cesarean section surgeries and it also decreases theneed for rescue analgesia required.

scholarly journals Comparison between the Outcome of Tunica Vaginalis Blanket Wrap and Non-wrap Procedures in Urethroplasty

2015 ◽  
Vol 3 (1) ◽  
pp. 30-36
Author(s):  
Mohammad Minhajuddin Sajid ◽  
Md Shahid Karim
Keyword(s):  
Ventral Surface ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Paediatric Surgery ◽  
Tunica Vaginalis ◽  
Total Period ◽  
Rate Of Development ◽  
Group A ◽  
Group B

Background: Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis, proximal to the end of glans. Fistulas are the most common complication following hypospadias repairs. This study was carried out to see that application of vascularized Tunica Vaginalis Blanket Wrap (TVBW) in urethroplasty reduces fistula rate in hypospadias repair. Objectives: To study the efficacy of Tunica vaginalis blanket wrap to prevent urethrocutaneous (UC) fistula in urethroplasty for hypospadias repair.Methods:Study Design : Prospective comparative studyPlace of Study :Department of Paediatric surgery, Dhaka Shishu Hospital (DSH), Dhaka.Period of Study :April, 2003 to October, 2004 for a total period of 19 months.The study of population : Twenty (20) admitted patients of hypospadias were selected. Patients were grouped into group A and group B on the basis of lottery method. Group A included 10 cases, who were subjected to repair of hypospadias with the application TVBW. Group B included 10 cases, who were subjected to repair of hypospadias without TVBW.Statistical Analysis : Chi-square test (X2 test) were applied. p value <0.01 was taken as significant.Ethical aspect : Research protocol was accepted by DSH. Written consent were taken from parents.Result: Occurrence of post operated UC fistula found significantly higher in non TVBW. Discussion: In our patients for group A (study group), TVBW was used in urethroplasty while urethroplasty for group B (control group) was carried out without TVBW. UC fistula was present in 1 patient (10%) in group A post operatively and in 5 patients (50%) in group B postoperatively and subsequently 2 more patients developed fistula during follow up period. In control group 7 patient (70%) developed UC fistula out of 10 patients (n=10) despite of using periurethral flap of tissue as second layer over the neourethra. In our study, the rate of development of UC fistula is much less (only 10%) in study group. So the result is significant as evidenced by p value which is less than <0.01.This study demonstrates that use of tunica vaginalis as a blanket wrap as second layer over the neourethra reduces the rate of development of UC fistula.Conclusion: TVBW is recommended for urethroplasty to decrease the postoperative UC fistula.J. Paediatr. Surg. Bangladesh 3(1): 30-36, 2012 (January)

Hepatoprotective Role of Propolis Extract to Prevent Hepatotoxic Effects of ATT in patients with Tuberculosis

2021 ◽  
Vol 15 (9) ◽  
pp. 2867-2869
Author(s):  
Asma Arshad ◽  
Saira Munawar ◽  
Rabia Sajjad Toor ◽  
Saba Saleem ◽  
Kanwal Sharif ◽  
...  
Keyword(s):  
Standard Dose ◽  
Ethanolic Extract ◽  
Control Group ◽  
Albino Rats ◽  
P Value ◽  
Average Weight ◽  
Propolis Extract ◽  
Measured Weight ◽  
Group B ◽  
Group D

Objective: The main purpose of this study is to evaluate the hepatoprotective effects of propolis in hepatocytes injury caused by ATT due to isoniazid and rifampicin. Methods: Healthy albino rats of with average weight of 200-250g were under this study. These rats dividing into main four groups, A group is taken a control group and then further into the group B, group C, and group D as group for experiments. The control group had 15 rats with measured weight, they were given distilled water. Group B had 15 rats, they were given with standard dose of rifampicin and isoniazid. Group c had 15 rats, they were also given with standard dose of rifampicin and isoniazid. Group D had 15 rats, they were given with standard dose of rifampicin and isoniazid and also extract of the propolis we prepared. Results: Serum ALT in the experimental group B with group C, group D were also found to be of statistically significant with p-value < 0.001. ALT serum level observed high in group B. Multiple comparison between groups revealed that group B with a significantly increase in the serum enzyme AST level in comparison to group A, group C and group D with p-value <0.001. Conclusion: This study showed that ethanolic extract of propolis prevents isoniazid and rifampicin induced hepatotoxicity in the albino rats. Key words; Propolis, Anti-tuberculosis treatment, Hepato-toxicity.

scholarly journals Effect of acupuncture TENS versus conventional TENS on post cesarean section incision pain

2018 ◽  
Vol 7 (9) ◽  
pp. 3738
Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Control Group ◽  
P Value ◽  
Random Allocation ◽  
Lower Segment Caesarean Section ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.

scholarly journals Association of single-nucleotide polymorphisms in the ESR2 and FSHR genes with poor ovarian response in infertile Jordanian women

2021 ◽  
Vol 48 (1) ◽  
pp. 69-79
Author(s):  
Amer Mahmoud Sindiani ◽  
Osamah Batiha ◽  
Esra’a Al-zoubi ◽  
Sara Khadrawi ◽  
Ghadeer Alsoukhni ◽  
...  
Keyword(s):  
Single Nucleotide Polymorphisms ◽  
Statistical Significance ◽  
Ovarian Response ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Nucleotide Polymorphisms ◽  
Poor Ovarian Response ◽  
Single Nucleotide ◽  
Number Of Patients

Objective: Poor ovarian response (POR) refers to a subnormal follicular response that leads to a decrease in the quality and quantity of the eggs retrieved after ovarian stimulation during assisted reproductive treatment (ART). The present study investigated the associations of multiple variants of the estrogen receptor 2 (ESR2) and follicle-stimulating hormone receptor (FSHR) genes with POR in infertile Jordanian women undergoing ART.Methods: Four polymorphisms, namely ESR2 rs1256049, ESR2 rs4986938, FSHR rs6165, and FSHR rs6166, were investigated in 60 infertile Jordanian women undergoing ART (the case group) and 60 age-matched fertile women (the control group), with a mean age of 33.60±6.34 years. Single-nucleotide polymorphisms (SNPs) were detected by restriction fragment length polymorphism and then validated using Sanger sequencing.Results: The p-value of the difference between the case and control groups regarding FSHR rs6166 was very close to 0.05 (p=0.054). However, no significant differences were observed between the two groups in terms of the other three SNPs, namely ESR2 rs1256049, ESR2 rs4986938, and FSHR rs6165 (p=0.561, p=0.433, and p=0.696, respectively).Conclusion: The association between FSHR rs6166 and POR was not statistically meaningful in the present study, but the near-significant result of this experiment suggests that statistical significance might be found in a future study with a larger number of patients.

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

scholarly journals Effects of Aqueous Extract of Basella alba L. leaves on Blood Cell Count in Rats

2019 ◽  
Vol 22 (1) ◽  
pp. 73-78
Author(s):  
Farhana Sabrin ◽  
AF Mohammed Shafiqul Alam ◽  
Muhammad Rashedul Islam ◽  
Md Elias Al Mamun ◽  
Jakir Ahmed Chowdhury
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Aqueous Extract ◽  
Control Group ◽  
P Value ◽  
Blood Cell Count ◽  
Basella Alba ◽  
Group A ◽  
Group B ◽  
Group D

The effect of aqueous extract of Basella alba (puishak) leaves on blood cell count of rats was studied. Forty rats of both sexes weighing between 100-150 gm were used. The rats were divided into four groups (7 rats in each group), with group A as the control group and experimental groups were denoted as B, C and D. With all aseptic precautions, aqueous extract of Basella alba (Puishak) leaves was administered into the three different doses (For group B: 60 mg/kg bw, group C: 80 mg/kg bw and group D: 100 mg/kg bw). Control group A also received distilled water as a placebo at the dose of 10 mg/kg bw for 14 days. At day 15, blood samples were collected and sent for haematological analysis. Data analysis of blood count profile of 28 rats revealed that there is an increased number of RBC, WBC and platelet count in experimental groups than in control group. ANOVA test revealed that increased blood cell counts following administration of aqueous leaves extract of keeves of B. alba were statistically significant (p value for each case was .0001<.05) than control group. Paired samples t test was performed to compare between baseline hematological parameters and parameters after 14 days of intervention. Then comparison between Group A & Group B, between Group A & Group C and between Group A & Group D were done. In all cases, probability (p) value < 0.05 was considered as statistically significant.This it is clearly evident that aqueous extract of B.alba has positive stimulant effect on blood cells count of rats. Moreover, it was found that increment of doses also increases the cell count that is positively correlated with the hypothesis. Bangladesh Pharmaceutical Journal 22(1): 73-78, 2019

scholarly journals A prospective study of efficacy of ultrasound guided transversus abdominis plane block for postcesarean analgesia

2019 ◽  
Vol 8 (5) ◽  
pp. 1951
Author(s):  
Sravani Manam ◽  
R. N. V. Swetha ◽  
A. S. Kameswara Rao ◽  
S. G. K. Murthy
Keyword(s):  
Total Dose ◽  
Postoperative Period ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Group B

Background: The ultrasound guided transversus abdominis plane (TAP) block which provides effective analgesia after lower abdominal surgeries including caesarean section. It is a simple and reliable technique. In this prospective, randomized double-blind study, we determined the efficacy of TAP block using 0.25% Bupivacaine and 0.9N Saline with respect to VAS for pain, postoperative Tramadol consumption and post-operative ondansetron usage.Methods: This study was conducted on 100 adult patients of ASA physical status I and II in the   age group of 18 to 40 years undergoing elective lower segment cesarean section under spinal anaesthesia. Study group received TAP block with 0.25% Bupivacaine and control group received 10 ml of 0.9N saline on each side. Patients were analyzed for postoperative pain by pain score (at rest, on movement, on cough) using VAS was recorded at 0, ½, 1, 2, 4, 6, 12 and 24 hours postoperatively. Need for rescue analgesia was assessed by time to first dose of Tramadol requirement and total dose of Tramadol over 24 hours of postoperative period. Ondansetron (4 mg i.v.) was administered whenever nausea score was more than 2 or the patient vomited. All the data was noted using uniform performs.Results: Patients received TAP block with 0.25% Bupivacaine had better pain scores at first hour of postoperative period during rest, cough and movement which was statistically significant (p<0.0010) in comparison to group B. There was a statistically significant difference (p <0.001) in the requirement of total dose of Tramadol as a rescue analgesia in patients who received transversus abdominis block with 0.25% Bupivacaine (138.77 mg) in comparison with other group(240 mg).The mean time to first request for Tramadol was significantly longer in group A (5.8 hrs)  in comparison to group B (1.93 hrs) with p value <0.001. Patients received TAP block with 0.9N saline needed more dose of Ondansetron, however, the difference was not statistically significant (p >0.001).Conclusions: TAP block using ultrasound provides substantial reduction in Tramadol consumption, time to first dose of rescue tramadol when compared with control group. This study reinforces the recommendation for TAP as a part of multimodal post-operative analgesic regimen.

scholarly journals Is Local Anesthetic Infiltration Prior to Intravenous Cannulation Beneficial to Patients?

2013 ◽  
Vol 8 (1) ◽  
pp. 10-13
Author(s):  
Babu Raja Shrestha ◽  
U Shrestha ◽  
A Shrestha ◽  
A Rana
Keyword(s):  
Heart Rate ◽  
Local Anesthetic ◽  
Randomized Study ◽  
Cardiovascular Responses ◽  
Control Group ◽  
Venous Cannulation ◽  
Number Of Patients ◽  
Group A ◽  
Group B ◽  
Local Anesthetic Infiltration

Aims: Intravenous cannulation causes pain, anxiety and frustration in patients along with changes in hemodynamic parameters. Infiltration of local anesthetic lessens the pain of intravenous cannulation. This study was performed to compare cardiovascular responses and verbal rating pain scores in two groups with and without local anesthetic infiltration prior to venous cannulation. Methods: This was a randomized study conducted in 100 elective surgical patients, divided into two study groups with 50 patients in each: group A (Control) and group B (local anesthetic infiltration). Prior to venous cannulation in group B, 0.5 ml of 1% lidocaine was infiltrated at the procedure site at dorsum of the wrist. Patients in group A were cannulated directly without local anesthetic infiltration. The hemodynamic changes pre and post cannulation and verbal pain rating scores were recorded by blind observers in all patients. Results: Demographic values in two groups were similar. Increase in heart rate from baseline value was significant in control group (p < 0.05). Post cannulation heart rate, systolic and diastolic blood pressure were significantly higher in group A compared to group B for the first three minutes (p < 0.05). Amongst higher number of patients in group A, verbal rating pain score was significantly higher. Ninety-four percent of the patients in group B were pain free, comfortable and satisfied with the procedure. Conclusions: Intravenous cannulation can be made pain free with patient satisfaction and hemodynamic stability if carried out with prior local anesthetic infiltration. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 10-13 DOI: http://dx.doi.org/10.3126/njog.v8i1.8853

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