scholarly journals Effects of Intraoperative Nefopam on Catheter-Related Bladder Discomfort in Patients Undergoing Robotic Nephrectomy: A Randomized Double-Blind Study

2019 ◽  
Vol 8 (4) ◽  
pp. 519
Author(s):  
Chi-Bum In ◽  
Young-Tae Jeon ◽  
Ah-Young Oh ◽  
Se-Jong Jin ◽  
Byeong-Seon Park ◽  
...  

Catheter-related bladder discomfort (CRBD) is one of the most difficult symptoms during the postoperative period. Nefopam is a non-narcotic analgesic agent, which also has anticholinergic action. This study was performed to evaluate the effects of nefopam on CRBD in male patients undergoing robotic nephrectomy. A total of 109 male patients were randomly divided into two groups: the control group (n = 55) received 20 mL of normal saline, and the nefopam group (n = 54) received 20 mg of nefopam 1 h before the end of the operation. At postoperative times of 20 min, 1 h, 2 h, and 6 h, the severity of CRBD was measured using an 11-point numeric rating scale, respectively. The severity of CRBD in the nefopam group was significantly lower than that in the control group at 20 min (4.8 ± 1.3 vs. 2.3 ± 1.0, respectively, p = 0.012) and at 1, 2, and 6 h (3.5 ± 1.2, 2.7 ± 0.9, and 2.5 ± 1.0 vs. 4.1 ± 0.8, 1.6 ± 0.8, and 1.3 ± 0.6, respectively, p < 0001). Intraoperative nefopam administration reduced the severity of CRBD in patients undergoing robotic nephrectomy.

2020 ◽  
Vol 39 (3) ◽  
pp. 27-31
Author(s):  
Oleg A. Litvinov ◽  
Evgeniy V. Zhitikhin ◽  
Igor G. Ignatovich ◽  
Hovannes A. Arutyunyan ◽  
Artur G. Arustamov ◽  
...  

A comparative analysis of the treatment of 142 patients operated on chronic hemorrhoid stage IIIIV has been passed by way of assess the results of using new version of hemorrhoidectomy. The age of patients ranged from 27 to 80 (mean age was 50.46.7). 86 (60.6%) patients were diagnosed with stage III chronic hemorrhoid, at 56 (39.4%) patients the stage IV. For this study patients were divided into basic and controlled groups. The basic group consisted of 73 (51.4%) patients that have had hemorrhoidectomy using our modification. There were 69 (48.6%) patients in control group that have been operated by MilliganMorgan method in second modify of State Scientific Center of Proctology using bipolar coagulator LigaSure. The level of pain was assessed in the early postoperative period by numeric rating scale. The patients had been operated by our method mentioned that the pain syndrome was less pronounced (3.2 against 4.9 balls), that required less painkillers in the early postoperative period. In the case of doing semicircle cuts on the border of anocutaneous crinkle and bringing down mucous membrane, the significant excision of the cavernous tissue doesnt lead to contraction of the anal canal by that reduces the number of functional disorders after hemorrhoidectomy (4 figs, 1 table, bibliography: 7 refs).


2018 ◽  
Vol 127 (5) ◽  
pp. 297-305 ◽  
Author(s):  
Kwan-Sub Kim ◽  
Nam-Kyung Yeo ◽  
Seong-Su Kim ◽  
Woong-Sub Park ◽  
Su-Hyun Kwak ◽  
...  

Purpose: Nasal packing is an option for bleeding control after endoscopic sinus surgery and septoplasty. Although new packing materials have been developed, patients still suffer from pain and require additional analgesics treatments. In this study, a prospective, randomized, and double-blind controlled trial was designed to evaluate the effect of fentanyl-soaked packing on pain after endoscopic sinus surgery and septoplasty. Methods: One hundred fifty-two patients who underwent nasal surgeries due to chronic rhinosinusitis or nasal septal deviation were enrolled in this study. At the end of operation, 50 mcg fentanyl-soaked biodegradable synthetic polyurethane foams packing Nasopore or Merocel were applied to a group of 79 patients, and saline-soaked ones were applied to another group of 73 patients. To evaluate the influence of fentanyl on postoperative nasal pain, patients’ conditions were assessed via means of Numeric Rating Scale, patient satisfaction, and Ramsay Sedation Scale. In addition, symptoms of headache or sore throat and any signs of cardiopulmonary-relevant indicators were monitored. Results: The fentanyl group had significantly decreased Numeric Rating Scale and increased patient satisfaction in every operation type for the majority of postoperative time periods ( P < .05) with reduced postoperative headache and sore throat compared to the control group. The fentanyl group showed a higher score on Ramsay Sedation Scale than the control group ( P < .05 in group including endoscopic sinus surgery). There were no significant differences in cardiopulmonary-relevant indicators between the 2 groups ( P > .05). Conclusion: Fentanyl group showed significantly reduced postoperative pain without serious adverse effects. We suggest that topical fentanyl application to nasal packs can be a useful method to reduce pain during the early postoperative period after endoscopic sinus surgery and septoplasty.


MEDISAINS ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. 57
Author(s):  
Qurota A'yun ◽  
Mukhoirotin Mukhoirotin

Background: The dysmenorrhea prevalence is still reported high in the world. Several previous studies discovered that deep breathing relaxation effectively reduced dysmenorrhea. Other studies presented the combination of early mobilization and spiritual relaxation could reduce the level of client pain postoperative appendectomy, however the effectiveness of spiritual relaxation techniques to reduce dysmenorrhea is not yet tested.Objective: to determine the effect of spiritual relaxation to reduce dysmenorrhea.Method: The research design used was Quasi Experiment with the pretest-posttest Control Group Design approach. The populations were female students who experienced menstrual pain (dysmenorrhea) and met the inclusion and exclusion criteria. The variable in this study was dysmenorrhea. The sampling technique was simple ramdom sampling consisted of 44 respondents. The calculation instrument was NRS (Numeric Rating Scale) and data were analyzed through statistical test of Paired T-Test and Independent T-Test.Results: After spiritual relaxation treatment, the intensity of menstrual pain reduced significantly from 6.05 - 1.77, it proved that there was an effect of spiritual relaxation on dysmenorrhea with a significant value (ρ) of 0.000 (p ≤ 0.05). There were significant differences in the intensity of menstrual pain in the intervention and control groups (1.77 ± 1,109 vs 5.63 ± 0.445; p> 0.05).Conclusion: Spiritual relaxation effectively reduces dysmenorrhea


2019 ◽  
Vol 11 (3) ◽  
pp. 117-125 ◽  
Author(s):  
Nicholas Leyland ◽  
Stephanie J Estes ◽  
Samantha Eichner ◽  
Ahmed M Soliman ◽  
Yabing Mai ◽  
...  

Background: The daily pain burden experienced by women with endometriosis has not been well studied. Objective: To characterize baseline pain among women with moderate-to-severe endometriosis-associated pain enrolled in phase 3 studies of elagolix, an oral, nonpeptide gonadotropin-releasing hormone antagonist. Study design: Data were pooled from the screening phase of two randomized, double-blind, placebo-controlled clinical trials. After cessation of endometriosis medications, patients entered the screening phase during which symptoms (dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia) and rescue medication use were recorded daily in electronic diaries. Endometriosis-associated pain was also scored using the Numeric Rating Scale (range 0–10). Baseline was defined as the last 35 days during the screening period. Results: Endometriosis-associated pain was reported by the 1686 study participants on most days during the baseline interval. Pain was often moderate or severe, with a mean Numeric Rating Scale score of 5.6 ± 1.7. Women reported dysmenorrhea an average of 8.1 ± 3.0 days (97.9% ± 7.0% of menstruating days), nonmenstrual pelvic pain on 20.5 ± 5.4 days (90.3% ± 15.8% of nonmenstruating days), and dyspareunia on 8.7 ± 8.0 days (81.7% ± 29.7% of sexually active days). When they occurred, dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia were frequently moderate or severe in intensity. Women were free of pelvic pain for an average of 2.4 ± 3.9 days during the 35-day evaluation interval. Conclusion: Among women with untreated moderate-to-severe endometriosis pain, the daily burden of pain was extensive, both during menstruation and on nonmenstruating days.


2017 ◽  
Vol 35 (2) ◽  
pp. 103-107 ◽  
Author(s):  
JaeWoo Song ◽  
HyukHoon Kim ◽  
EunJung Park ◽  
Jung Hwan Ahn ◽  
Eunhui Yoon ◽  
...  

ObjectiveSubcutaneous local anaesthetic injection can be painful to patients in the ED. We evaluated the effect of cryotherapy by application of an ice cube to the injection site prior to injection in patients with simple lacerations.MethodsWe conducted a prospective, randomised, controlled trial in consented patients with simple lacerations needing primary repair at a single emergency centre from April to July 2016. We randomly assigned patients undergoing repair for simple lacerations to either the cryotherapy group or the control group (standard care; no cryotherapy or other pretreatment of the injection site). In cryotherapy group subjects, we applied an ice cube (size: 1.5×1.5×1.5 cm) placed inside a sterile glove on the wound at the anticipated subcutaneous lidocaine injection site for 2 min prior to injection. The primary outcome was a subjective numeric rating (0–10 scale) of the perceived pain from the subcutaneous local anaesthetic injections. Secondary outcomes were (a) perceived pain on a numeric scale for cryotherapy itself, that is, pain from contact of the ice cube/glove with the skin and (b) the rate of complications after primary laceration repair.ResultsFifty patients were enrolled, consented and randomised, with 25 in the cryotherapy group and 25 in the control group. The numeric rating scale for subcutaneous anaesthetic injections was median, IQR, 95% CI 2.0 (1 to 3.5), 1.81 to 3.47, respectively, in the cryotherapy group and 5.0 (3 to 7), 3.91 to 6.05 in the control group (Mann-Whitney U=147.50, p=0.001). No wound complications occurred in either group. The numeric rating scale for cryotherapy itself was median, IQR, 95% CI: 2.0 (1 to 3.5), 1.90 to 3.70.ConclusionPre-emptive topical injection site cryotherapy lasting 2 min before subcutaneous local anaesthetic injections can significantly reduce perceived pain from subcutaneous local anaesthetic injections in patients presenting for simple laceration repair.Trial registration numberKCT0001990.


2019 ◽  
Vol 2 (1) ◽  
pp. 1-14
Author(s):  
Astrid Astrid ◽  
Memed Sena Setiawan

Apendicitis adalah peradangan dari apendiks vermiformis yang menyebabkan usus berhenti mengeluarkan sisa makanan yang tidak diserap oleh tubuh sehingga dilakukan Apendictomy dimana terjadi nyeri akut pada level severe. Tujuan penelitian ini untuk mengetahui pengaruh teknik relaksasi Guided Imagery Music terhadap intensitas nyeri post operasi apendicitis di ruang rawat inap bedah RSPAD Gatot Soebroto Ditkesad Jakarta. Desain penelitian menggunakan purposive sampling dengan rancangan random assignment pre test-post test with control group. Jumlah sampel adalah 36 orang (18 orang kelompok kontrol dan 18 orang kelompok intervensi). Nyeri diukur dengan menggunakan Numeric Rating Scale (NRS) dan Faces Pain Scale Resived (FPSR). Uji statistik menggunakan uji T test independen. Hasil uji menunjukkan ada pengaruh teknik relaksasi Guided Imagery Music terhadap intensitas nyeri pada klien post operasi Apendicitis. Perbedaan rata-rata intensitas nyeri pada kelompok kontrol sebesar 1,55 dan pada kelompok intervensi sebesar 3,17. Variabel confounding telah dilakukan uji normalitas didapatkan hasil tidak ada hubungan usia, jenis kelamin, koping, individu pendukung, lingkungan, pengalaman nyeri sebelumnya terhadap intensitas nyeri, ini dikarenakan klien tidak mampu mengalihkan perhatian dari rasa nyeri yang hebat post operasi apendicitis, sehingga hasil statistik nya tidak perlu dilakukan transformasi. Teknik relaksasi Guided Imagery Music dapat digunakan sebagai intervensi mandiri keperawatan untuk mengurangi intensitas nyeri klien post operasi apendicitis. Kata Kunci: Guided Imagery Music, Klien Post Operasi Apendicitis, Intensitas Nyeri


Author(s):  
Gita Kostania ◽  
Kuswati Kuswati ◽  
Ati Fitriyani

Latar Belakang : Menstruasi merupakan tanda pubertas seorang wanita dan menjadi rutinitas wanita yang masih dalam masa subur. Siklus ini menimbulkan ketidaknyamanan, salah satunya nyeri menstruasi. Nyeri ini dapat berupa kram ringan hingga dapat mengganggu kegiatan sehari-hari. Nyeri menstruasi dapat dikurangi secara farmakologis dan non farmakologis. Secara non farmakologis salah satunya adalah dengan akupresure pada titik Hegu. Tujuan : Penelitian ini bertujuan untuk mengetahui pengaruh akupresure titik hegu terhadap nyeri menstruasi. Metode : Penelitian ini merupakan penelitian observasional. Jenis penelitian quasy eksperiment dengan rancangan non equivalent control group. Populasi aktualnya yaitu santriwati kelas XI Madrasah Bertaraf Internasional Amanatul Ummah Mojokerto yang mengalami nyeri menstruasi sebanyak 126 orang. Teknik pengambilan sample adalah purposive sampling dengan perhitungan rumus Slovin, didapatkan sebanyak 56 responden. Instrumen penelitian menggunakan lembar observasi dengan pengukuran Numeric Rating Scale. Analisis data menggunakan independent t-test. Hasil : Hasil penelitian menunjukkan bahwa terdapat perbedaan penurunan nyeri menstruasi antara kelompok eksperimen dan kelompok kontrol dengan p=0,001 (p


Author(s):  
Qanita Chairun Nissa ◽  
Neni Nuraeni ◽  
Hani Handayani

Dysmenorrhea is menstruation pain that would interfere women’s activities. Murattal is a non-pharmacological technique that may relieve menstruation pain. The aim of this research was to find the effect of Murattal in relieving dysmenorrhea for female student of SMPN 12 Tasikmalaya. This research used quasi-experiment with pre-posttest and control group design. Respondents were selected using purposive sampling technique. This study involved 15 students in a group treatment and 15 students in a group control used technique purposive sampling. The instrument of this study was Numeric Rating Scale (NRS) Instrument. Respondents listened Murattal Surah Ar-Rahman. Data were analyzed using paired T-Test also used. The result found that there was an effect of Murattal to relieve dysmenorrhea pain for female student of SMPN 12 Tasikmalaya, with ρ value 0,000. The conclusion, Murattal is effective to relieve dysmenorrhea. There is a need of developing other non-pharmacology interventions to relive dysmenorrhea Keywords: Dysmenorrhea, Murottal, Pain


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029449 ◽  
Author(s):  
Berzenn Urbi ◽  
Simon Broadley ◽  
Richard Bedlack ◽  
Ethan Russo ◽  
Arman Sabet

IntroductionAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no known cure and with an average life expectancy of 3–5 years post diagnosis. The use of complementary medicine such as medicinal cannabis in search for a potential treatment or cure is common in ALS. Preclinical studies have demonstrated the efficacy of cannabinoids in extending the survival and slowing of disease progression in animal models with ALS. There are anecdotal reports of cannabis slowing disease progression in persons with ALS (pALS) and that cannabis alleviated the symptoms of spasticity and pain. However, a clinical trial in pALS with these objectives has not been conducted.Methods and analysisThe Efficacy of cannabis-based Medicine Extract in slowing the disease pRogression of Amyotrophic Lateral sclerosis or motor neurone Disease trial is a randomised, double-blind, placebo-controlled cannabis trial in pALS conducted at the Gold Coast University Hospital, Australia. The investigational product will be a cannabis-based medicine extract (CBME) supplied by CannTrust Inc., Canada, with a high-cannabidiol-low-tetrahydrocannabinol concentration. A total of 30 pALS with probable or definite ALS diagnosis based on the El Escorial criteria, with a symptom duration of <2 years, age between 25 and 75years and with at least 70% forced vital capacity (FVC) will be treated for 6 months. The primary objective of the study is to evaluate the efficacy of CBME compared with placebo in slowing the disease progression measured by differences in mean ALS Functional Rating Scale-Revised and FVC score between the groups at the end of treatment. The secondary objectives are to evaluate the safety and tolerability of CBME by summarising adverse events, the effects of CBME on spasticity, pain, weight loss and quality of life assessed by the differences in mean Numeric Rating Scale for spasticity and Numeric Rating Scale for pain, percentage of total weight loss and ALS specific quality of life-Revised questionnaire.Ethics and disseminationThe study has been approved by the local Institutional Review Board. The results of this study will be published in a peer-reviewed journal.Trial registration numberNCT03690791


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