scholarly journals Electronically monitored single-use patient-controlled analgesia pumps in postoperative pain control

2005 ◽  
Vol 1 (5) ◽  
pp. 267
Author(s):  
Michael Zimmermann, MD ◽  
Karin Friedrich, MD ◽  
Rolf Kirchner, MD
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Pain Control ◽  
Opioid Consumption ◽  
Dose Titration ◽  
Patient Controlled Analgesia ◽  
Analgesic Consumption ◽  
Group A ◽  
Single Use ◽  
Group B

The present study was performed to establish whether analgesic consumption in the first four postoperative hours is a suitable basis for selecting the demand dose and predicting the likely analgesic requirement over the next 20 hours with single-use patient-controlled analgesia (PCA) pumps, and to establish whether this method provides effective pain control.Forty-two patients who had undergone a laparotic gynecological procedure (hysterectomy) were given an electronic PCA pump (Abbott Lifecare, Abbott Laboratories, Abbott Park, IL) for four hours (phase I) with a demand dose of 1 mg piritramide and a lockout period of five minutes for dose titration. Piritramide’s potency is comparable with that of morphine. The patients then received single-use PCA pumps (Baxter Infusor/Watch, Baxter, Deerfield, IL) for the next 20 hours (phase II) with a demand dose of 0.75 mg in Group A and 1.5 mg in Group B, depending on whether more or less than 10 mg pritramide had been consumed in phase I. A specially designed electronic recorder was used to measure the exact amount consumed and number of demands. Patients experiencing pain were free to receive additional piritramide at any time as rescue medication; however, these patients were withdrawn from the study.Ninety percent of the patients in group A said they were satisfied with or undecided as to the level of analgesia. The corresponding figure in group B was 95 percent. Piritramide consumption was significantly higher in group B than in group A. There were no significant differences between the groups regarding demographic data or duration of surgery, nor did either of these two parameters affect postoperative piritramide consumption. Significant alleviation of pain and improvement in visual analog scale scores from phase I [group A, 4.7 (range, 2.0 to 6.8); group B, 4.6 (range, 3.0 to 8.3)] to phase II [group A, 3.1 (range, 0.4 to 5.2); group B, 3.2 (range, 0.4 to 6.0)] was achieved in both groups. A significant difference in analgesic consumption up to 18 hours postoperatively was seen after dose titration. In the first four hours, the rate of successful demands was significantly higher in group A (80.9 percent) than in group B (40.9 percent). The number of successful demands was comparable in the two groups during phase II (A, 98.8 percent; B, 94.5 percent).In summary, total opioid consumption during the first four hours after operation showed two groups of patients with significantly different needs for piritramide (< 10 mg per 4 hours or > 10 mg per 4 hours). Two different dose regimes were applied using a high and a low bolus size in the following 20 hours. We concluded that effective pain control without respiratory depression was achieved with single-use PCA pumps. Opioid consumption varied significantly, whereas pain levels did not.

Quality of life assessment in patients above 60, below 50 years of age during and after curative radiotherapy in head and neck cancers

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5552-5552 ◽  
Author(s):  
A. Turaka ◽  
B. K. Mohanti ◽  
S. Chander ◽  
S. V. Deo ◽  
R. Jena ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Phase I ◽  
Head And Neck ◽  
Phase Ii ◽  
Younger Patients ◽  
Curative Radiotherapy ◽  
Group A ◽  
Group B

5552 Background: To evaluate the Quality of life in patients above 60 and below 50 years during and after curative radiotherapy in head and neck cancers. Methods: Head and Neck cancer patients who are to undergo curative radiotherapy (RT) were divided into two groups, 49 patients (Group A,above 60 years) and 40 patients (Group B,below 50). Quality of life assessment was done using EORTC QLQ C-30 version-2 at 4 phases;Pretreatment-Phase I,during RT-Phase II,1-month post RT-Phase III and 6 months post RT-Phase IV.Statistical analysis was done with mean scores using ’t’ test. Results: Physical functioning (PF)scores in both groups were highest in phase I (69.4;77.5, p < 0.035) and lowest in phase II (40; 50, p < 0.008) and the difference was statistically significant. Although PF scores declined in both groups in phase II, overall PF score remained higher in group B than in group A in all phases.Role functioning score remained low in both groups and the difference were not statistically significant at all phases. Emotional functioning score was highest in phase I (68.37; 69.15), but declined as treatment progressed, consequent to depression.The values improved over time, restored to near pretreatment values at phase IV. Cognitive functioning scores in both groups was also highest in phase I (70.07; 79.17). Social functioning of both groups declined during RT (42.52; 45)compared to pre RT values (73.47; 77.09). The mean Global Health Status score was higher in group B compared to group A at all phases, yet there was no statistical significance.The scores declined during RT (66.87 vs 35.62 & 64.79 vs 34.01), improved overtime but did not reach pre RT scores.The symptom scores were all higher for elderly patients compared with younger patients at all phases, implying elderly patients experienced more symptoms, with greater experience of symptoms during RT. Conclusions: Quality of Life of elderly patients was lower compared to younger patients at phase II in terms of physical functioning, social and emotional functioning. Global Health Status score was higher for younger patients than elderly at all phases, and declined in phase II. No significant financial relationships to disclose.

scholarly journals Deqi Sensation in Placebo Acupuncture: A Crossover Study on Chinese Medicine Students

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Zhao-hui Liang ◽  
Chang-cai Xie ◽  
Zi-ping Li ◽  
Xiao-ping Zhu ◽  
Ai-ping Lu ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Phase I ◽  
Phase Ii ◽  
Clinical Trial Registry ◽  
Placebo Acupuncture ◽  
Real Acupuncture ◽  
Group A ◽  
The Difference ◽  
Two Phases ◽  
Group B

Objective. To evaluate the similarity of deqi sensation of real and noninvasive placebo acupuncture in healthy people with knowledge of Chinese medicine.Methods. In a crossover design, volunteers recruited from Chinese medicine college students were randomized to two groups to receive two phases of intervention with a one-week washout interval. In Group A, the participants were firstly treated by real acupuncture and then by sham needle, and the treatment sequence was reversed in Group B. VAS for pain intensity and deqi sensation was evaluated as outcomes.Results. Sixty-three volunteers were recruited and 60 were included and finished the study. In Group A, VAS was higher in Phase I than in Phase II (P=0.017). Only treatment methods were selected as factor to VAS difference (P=0.046) in ANOVA test. More positive deqi was reported in Group A in Phase I when treated by real acupuncture (P=0.039), but the difference was not significant in Phase II (P=0.301).Conclusion. The noninvasive placebo acupuncture device can effetely simulate the deqi sensation as real acupuncture, but it is less likely to evoke the active effect of deqi in real practice. This trial is registered with Chinese Clinical Trial Registry:ChiCTR-ORC-09000505.

Effects of Edoxaban on the Cellular and Protein Phase of Coagulation in Patients with Coronary Artery Disease on Dual Antiplatelet Therapy with Aspirin and Clopidogrel: Results of the EDOX-APT Study

2019 ◽  
Vol 120 (01) ◽  
pp. 083-093 ◽  
Author(s):  
Francesco Franchi ◽  
Fabiana Rollini ◽  
Emilio Garcia ◽  
Jose Rivas Rios ◽  
Andrea Rivas ◽  
...  
Keyword(s):  
Phase I ◽  
Antiplatelet Therapy ◽  
Phase Ii ◽  
Low Dose ◽  
Dual Antiplatelet Therapy ◽  
High Dose ◽  
Once Daily ◽  
Daily Group ◽  
Group A ◽  
Group B

AbstractIn patients requiring dual antiplatelet therapy (DAPT) who also have an indication to be treated with oral anticoagulant (OAC) drugs, aspirin withdrawal reduces the risk of bleeding. There is limited data on the pharmacodynamic effects associated with adding a nonvitamin K antagonist OAC on a background of aspirin and a P2Y12 inhibitor as well as dropping aspirin. Seventy-five patients on DAPT (aspirin plus clopidogrel) were randomized to DAPT plus high-dose edoxaban (60 mg once daily, Group A), DAPT plus low-dose edoxaban (30 mg once daily, Group B), or DAPT only (Group C) for 10 ± 2 days (Phase I). Afterwards, Groups A and B interrupted aspirin and maintained clopidogrel plus edoxaban for 10 ± 2 days, while patients in Group C maintained DAPT (Phase II). Platelet aggregation and clot kinetics were assessed at baseline, end of Phase I, and end of Phase II using thrombelastography (TEG), light transmittance aggregometry (LTA), VerifyNow P2Y12, and serum thromboxane-B2. The primary endpoint was the comparison of maximum amplitude (MA) measured by TEG, a measure of clot strength, between patients on DAPT plus high-dose edoxaban and patients on DAPT only. Edoxaban prolonged in a dose-dependent manner speed of thrombin generation (TEG R; Group A: 7.7 [6.8–8.7] vs. Group B: 7.4 [6.4–8.5] vs. Group C: 6.3 [5.7–7.0]; p = 0.05) but did not affect other markers of clot kinetics, including TEG MA (Group A: 63 [61–64] vs. Group B: 65 [63–67] vs. Group C: 64 [63–65]; p = 0.10). After aspirin discontinuation, platelet reactivity assessed by LTA using thrombin receptor activating peptide as agonist increased to a greater extent with low-dose edoxaban. Stopping aspirin did not affect markers of P2Y12 reactivity and had no or marginal effects on clot kinetics, but increased markers sensitive to cyclooxygenase-1 blockade.

scholarly journals A study to compare the effectiveness of core strengthening exercises for phase I and phase II of menstrual cycle in primary dysmenorrhea subjects

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 315-317
Author(s):  
S Zainab ◽  
P. Nithyashree ◽  
R Jumanah ◽  
M Kamalakannan ◽  
Suganthirababu Prathap ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Menstrual Cycle ◽  
Phase I ◽  
Phase Ii ◽  
Primary Dysmenorrhea ◽  
Significant Difference ◽  
Strengthening Exercises ◽  
Group A ◽  
Group B

Introduction and Aim:The common gynaecological problem among females found to be Dysmenorrhea, which is a cramping pain in the lower abdomen occurring at menstruation in the absence of any identifiable pelvic disease with a prevalence rate of 60%-90%. The consequences of primary dysmenorrhea affect quality of life (QOL) and limitations in daily activities as well as absenteeism. There is no open literature on which phase of the menstrual cycle is better to exercise in and is more effective. The aim of this study was to compare the effectiveness of core strengthening exercises for Phase I and Phase II of menstrual cycle in primary dysmenorrhea subjects and find out which phase is best to exercise in.   Materials and Methods: A total of 150 subjects were selected using convenient sampling technique based on inclusion and exclusion criteria and randomly allotted into 2 groups (group A and group B)containing 75 subjects each. Group A (Phase I follicular phase)and group B (Phase II luteal phase) performed core strengthening exercise protocol for a duration of 3 menstrual cycles (12 weeks). Working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) score as well as EQ 5-D 5-L (Euroql5 dimension 5 level quality of life questionnaire) values were obtained before and after the intervention.   Results: An unpaired t-test of the post-test mean values of phase I and II groups show that there is a significant difference between the two groups(p-value<0.0001)   Conclusion: From the results,it can be concluded that there is a significant difference in effectiveness of core strengthening exercises between phase I and phase II and thus exercising in Phase I is most effective.  

scholarly journals Can Combination of Peripheral Nerve Block and Non-opioidal Patient Controlled Analgesia Be an Effective Postoperative Pain Control Method?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0023
Author(s):  
Chan Kang ◽  
Gi Soo Lee ◽  
Dong Yeol Kim ◽  
Jeong-kil Lee ◽  
Ki Jun Ahn ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Control ◽  
Control Method ◽  
Patient Controlled Analgesia ◽  
Ultrasound Guided ◽  
Bone Surgery ◽  
Pain Scores ◽  
Group A ◽  
Group B

Category: Ankle, Pain medicine Introduction/Purpose: Even though bone surgery is very painful after operation, there is no established method to control postoperative pain due to efficacy and side effects. Ultrasound-guided peripheral nerve block (PNB) and nonsteroidal anti- inflammatory drugs (NSAIDs) patient controlled analgesia (PCA) can effectively control pain and reduce side effects. Methods: We conducted a prospective study of 150 patients over 18 years of age who underwent bone surgery from June 2018 to December 2018. All operations were performed under anesthetic ultrasound-guided PNB and additional PNB was performed to control postoperative pain. Among the 120 patients who participated in the final study, NSAIDs PCA was used in group A (65 patients) and NSAIDs PCA was not used in group B (55 patients) for pain control. Postoperative management except PCA was same in both groups. Pain scores are measured at 6, 12, 18, 24, 36, 48, and 72 hours after the operation and they were compared using visual analogue scale (VAS) pain scores. Survey was done on satisfaction of patients, and their willingness to reconsider same method of pain control when they undergo same surgery next time. Also, we evaluated possible side effects that might happen during process of controlling pain. Results: VAS pain score were significantly different only at 24 h postoperatively (p=0.004). In Group A, three patients were prescribed 3 amples of pethidine intramuscular injection as rescue analgesic. In group B, 35 patients were prescribed 50 amples of pethidine and 12 patients of them were received additional 18 amples of ketorolac intramuscular injection as rescue analgesic(p=0.000). In group A, all patients were satisfied with the pain control method, but 5 of the group B patients were dissatisfied (p=0.001). 3 patients responded to severe pain after operation and 2 of them due to postoperative nausea and vomiting (PONV). In group A, there were no patients complaining of PONV, but in group B, 5 patients complained of symptoms (p=0.018), and 3 of them were prescribed additional antiemetics (p=0.093). Conclusion: Combined use of ultrasound-guided PNB and NSAIDs PCA seems to be an effective postoperative pain control method in foot and ankle surgery. Because, pain can be effectively controlled and PONV can be reduced.

Efficacy and safety of nivolumab and trabectedin in pretreated patients with advanced soft tissue sarcomas (STS): Preliminary results of a phase II trial of the German Interdisciplinary Sarcoma Group (GISG-15, NitraSarc) for the non-L sarcoma cohort.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11545-11545
Author(s):  
Daniel Pink ◽  
Dimosthenis Andreou ◽  
Anne Flörcken ◽  
Alexander Golf ◽  
Stephan Richter ◽  
...  
Keyword(s):  
Phase Ii ◽  
Single Agent ◽  
Primary Efficacy ◽  
Primary Efficacy Endpoint ◽  
Efficacy And Safety ◽  
Disease Stabilization ◽  
Group A ◽  
Pretreated Patients ◽  
Grade 3 ◽  
Group B

11545 Background: Single-agent PD-1 inhibitors have modest activity in the treatment of most STS. Potential strategies to increase efficacy include combination therapies targeting the tumor microenvironment. Considering that apart from direct growth inhibition and death of malignant cells, trabectedin (Tr) also induces macrophage depletion and/or different immunologic effects, suggesting a possible synergistic effect of combined Tr plus anti-PD-1 treatment. We therefore aimed to evaluate the efficacy and safety of combined Tr and nivolumab (Ni) as a second-line treatment in STS. Methods: The prospective, explorative, two group, non-randomized phase II NiTraSarc trial enrolled pretreated patients (pt) with advanced STS (Group A: lipo- or leiomyosarcomas, Group B: non-L-sarcomas). Pt were initially treated with 3 cycles of Tr 1.5 mg/m2, followed by the combination of Tr 1.5 mg/m2 + Ni 240 mg (“late combination cohort” (LCC)) for up to 16 cycles. After positive results of a preplanned interim analysis, pt received the combination therapy starting with cycle 2 (“early combination cohort” (ECC)). 92 pt were recruited to the trial (55 in Group A, 37 in Group B). Primary efficacy endpoint is progression-free survival rate after 6 months (PFSR6) according to RECIST v.1.1. This is a first analysis of the primary efficacy endpoint in Group B based on a modified intention-to-treat (mITT) population of evaluable 36 pt: 23 and 13 pt from the LCC and ECC, respectively. Results: The most common Group B subtypes comprised undifferentiated pleomorphic/not otherwise specified sarcoma (UPS/NOS, 13pt) and fibromyxoid sarcoma (FMS, 6pt). After a median follow-up of 5 months (m) PFSR6 was 13.9% for all pt, 8.7% in LCC and 23.1% in ECC. Median duration of disease stabilization (DoDS) was 4m in all pt, the LCC and the ECC. Two pt had a partial response (PR), 10 had disease stabilization (SD), while 13 pt progressed, and 11 had missing data. By subtype: PR- UPS/NOS=2 (DoDS 12.7m/12.5m). SD: UPS/NOS=3, epithelioid=2, synovial=2, FMS=1, fibrosarcoma=1, other=1. All 36 pt experienced at least one adverse event (AE) reaching a total of 579 AEs, 141 (24.4%) of which were considered to be grade ≥3 treatment-related AEs. The main grade ≥3 AEs were: leukopenia (47.2% of pt), neutropenia (41.7% of pt), thrombocytopenia (33.3% of pt), increased ALT (30.6% of pt), and anemia (27.8% of pt). Conclusions: Tr+Ni was well tolerated and showed activity in at least some patients with non-L-sarcomas (mostly UPS/NOS) especially in the ECC. Analyses of the collected data, including PD-L1 expression profile, with the goal to establish whether Tr+Ni should be further pursued in these patients, are ongoing. ClinicalTrials.gov Identifier: NCT03590210; EudraCT: 2017-001083-38. Clinical trial information: NCT03590210.

scholarly journals Pain and discomfort during the first week of rapid maxillary expansion (RME) using two different RME appliances: A randomized controlled trial

2016 ◽  
Vol 87 (3) ◽  
pp. 391-396 ◽  
Author(s):  
Ingalill Feldmann ◽  
Farhan Bazargani
Keyword(s):  
Pain Intensity ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Analgesic Consumption ◽  
Function Impairment ◽  
Group A ◽  
Jaw Function ◽  
Group B ◽  
Median Pain ◽  
Hyrax Appliance

ABSTRACT Objectives: To evaluate and compare perceived pain intensity, discomfort, and jaw function impairment during the first week with tooth-borne or tooth-bone–borne rapid maxillary expansion (RME) appliances. Materials and Methods: Fifty-four patients (28 girls and 26 boys) with a mean age of 9.8 years (SD 1.28 years) were randomized into two groups. Group A received a conventional hyrax appliance and group B a hybrid hyrax appliance anchored on mini-implants in the anterior palate. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment on the first and fourth days after RME appliance insertion. Results: Fifty patients answered both questionnaires. Overall median pain on the first day in treatment was 13.0 (range 0–82) and 3.5 (0–78) for groups A and B, respectively, with no significant differences in pain, discomfort, analgesic consumption, or functional jaw impairment between groups. Overall median pain on the fourth day was 9.0 (0–90) and 2.0 (0–71) for groups A and B, respectively, with no significant differences between groups. There were also no significant differences in pain levels within group A, while group B scored significantly lower concerning pain from molars and incisors and tensions from the jaw on day 4 than on the first day in treatment. There was a significant positive correlation between age and pain and discomfort on the fourth day in treatment. No correlations were found between sex and pain and discomfort, analgesic consumption, and jaw function impairment. Conclusions: Both tooth-borne and tooth-bone–borne RME were generally well tolerated by the patients during the first week of treatment.

Phase I/II Study of Ipilimumab for Patients With Metastatic Melanoma

2008 ◽  
Vol 26 (36) ◽  
pp. 5950-5956 ◽  
Author(s):  
Jeffrey S. Weber ◽  
Steven O’Day ◽  
Walter Urba ◽  
John Powderly ◽  
Geoff Nichol ◽  
...  
Keyword(s):  
Phase I ◽  
Metastatic Melanoma ◽  
Complete Response ◽  
Pharmacokinetic Profile ◽  
Maximum Tolerated Dose ◽  
Primary Objective ◽  
Clinical Activity ◽  
Multiple Doses ◽  
Group A ◽  
Group B

PurposeThe primary objective of this phase I/II study was to determine the safety and pharmacokinetic profile of either transfectoma- or a hybridoma-derived ipilimumab. Secondary objectives included determination of a maximum-tolerated dose and assessment of clinical activity.Patients and MethodsEighty-eight patients with unresectable stage III or IV melanoma with at least one measurable lesion were treated. Mean age was 59 years, with 65% male and 35% female patients, and 79% of patients had received prior systemic therapy. Single doses of ipilimumab up to 20 mg/kg (group A, single dose), multiple doses up to 5 mg/kg (group A, multiple dose), and multiple doses up to 10 mg/kg (group B) were administered.ResultsSingle dosing up to 20 mg/kg of transfectoma antibody was well tolerated, as were multiple doses up to 10 mg/kg without a maximum-tolerated dose. In group B, dose-limiting toxicity was seen in six of 23 melanoma patients. Grade 3 or 4 immune-related adverse events (irAEs) were observed in 14% of patients (12 of 88 patients), and grade 1 or 2 irAEs were seen in an additional 58%. The half-life of ipilimumab was 359 hours. In group B, there was one partial response (23+ months), one complete response (21+ months), and seven patients with stable disease (SD), for a disease control rate of 39%. Two patients in group B with SD had slow, steady decline in tumor burden that was ongoing at 1 year of observation.ConclusionIpilimumab has activity in patients with metastatic melanoma. Late responses were observed in patients with prolonged SD.

scholarly journals Comparison between subcutaneous ketamine with intramuscular pethidine versus intramuscular pethidine for post-operative analgesia after cesarean section

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B M E Noureldin ◽  
M M Kamal ◽  
A A A Bedewy ◽  
H M M Sultan
Keyword(s):  
Cesarean Section ◽  
Total Dose ◽  
Pain Control ◽  
Well Being ◽  
University Hospitals ◽  
Common Procedure ◽  
Operative Care ◽  
Group A ◽  
Group B ◽  
The Cost

Abstract Background Cesarean section is one of the most common operations. Women undergoing cesarean delivery should achieve adequate postoperative pain relief because of different factors related to the operation complications as well as maternal and neonatal well-being. Immobility due to inadequate pain control could result in thrombo-embolic events, inappropriate neonatal care and delay in discharge which consequently increase the cost of this common procedure both for patients and health care system. Objective to investigate the efficacy of adding subcutaneous ketamine for postoperative analgesia in cesarean section and comparing it to using intramuscular pethidine only regarding opioid requirements and pain level. Patients and Methods The present study was carried out on two groups of women (each group consists of 25) after undergoing cesarean section under spinal anesthesia in Ain Shams University Hospitals and Helwan University Hospitals. Group A patients were given three doses of subcutaneous ketamine (0.9 mg/kg) at post-operative care unit (PACU), 12 and 24 hours after the operation with intramuscular pethidine (50mg) given when patients’ numerical pain score exceeded 5. Group B patients were given three doses of placebo at same intervals as group A and were given intramuscular pethidine (50mg) when NRS score exceeded 5. Results There was significant decrease in pain scores between two groups PACU, 12 and 24 hours postoperative with no significant change in the rest of the study. There was highly significant increase in the time to first pethidine demand in group A than B. There was highly significant decrease in total dose of pethidine given (in group A than in B. Conclusion Subcutaneous ketamine with a dose of (0.9mg/kg) can be used in reducing pain in postoperative period after CS with minimal side effects. The addition of SC ketamine to the pethidine appear to cause more pain control and decrease the total dose of pethidine given in post-operative period.

scholarly journals Efficacy of Tamsulosin in the Medical Management of Juxtavesical Ureteral Stones: A Randomized Control Trial

2017 ◽  
Vol 42 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Abu Sayeed Md. Feroz Mustafa ◽  
Md. Saiful Islam ◽  
Abdullah Al Mamun ◽  
Muhammad Syeef Khalid
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Randomized Control Trial ◽  
Dose Titration ◽  
Ureteral Stones ◽  
Common Disease ◽  
Group A ◽  
Randomized Control ◽  
Group B

Urolithiasis is the third most common disease of the urinary tract. Among all urinary tract stones, majorities are ureteral stones located in the distal part of the ureters. At present, multimodalities of treatment are available to the urologists. The purpose of the present study was to observe the efficacy of Tamsulosin in conventional treatment of juxtavesical ureteric stone having size up to 8 mm. This was a single centered, parallel randomized control trial carried out in the outpatient department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from July 2007 to June 2008. The patients with unilateral, juxtavesical ureteral stone with normal functioning kidney and absence of clinical and laboratory signs of urinary tract infection and stone size up to 8 mm were included in the study. Patients were divided into two groups according to the computer generated simple random sampling. Patients of Group-A  were given conventional hydrotherapy treatment and patients of Group-B were given Tamsulosin 0.4mg/day along with the conventional hydrotherapy. Each patient was followed-up weekly until stone expulsion for 4 weeks. In Group-A and Group-B, the mean age with SD was 38.55±10.05 and 37.7±9.33 years. Expulsion occurred in 32 (53.33%) of 60 patients in Group-A and 51 (85%) of 60 patients in Group-B (p <0.05). The number of pain episodes in this study was statistically significantly lower in Group-B patients compared to Group-A (p <0.05). Urinary tract infection was encountered in 12 (20%) patients of Group-A and 2 (3.33%) patients of Group-B (p <0.05) during four weeks therapy which was treated by appropriate antibiotics. No side effects of Tamsulosin were encountered in any patients of Group-B which could require the cessation of the medication or might need for dose titration. Findings of the study revealed that the Tamsulosin supplemented conventional therapy is more effective than conventional hydrotherapy alone in management of juxtavesical ureteral stones.

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