[Comparison of granisetron and lidocaine on reducing injection pain of etomidate: a controlled randomized study]

Paracetamol versus Paracetamol Plus Ondansetron on Acute Postoperative Pain

This study was performed to determine the comparative efficacy of paracetamol alone versus paracetamol plus ondansetron on acute postoperative pain after abdominal surgeries in Azad University hospitals in 2017 and 2019. In this randomized clinical trial, 62 consecutive patients under abdominal surgeries, were randomly divided into two groups, group 1 patient who received paracetamol alone 1 gram and group 2 patient who received paracetamol 1 gram plus 4 mg ondansetron and the pain severities were determined and compared between groups at recovery and after 4 and 24 hours. The results of this study revealed that there were no statistically significant differences between two groups for the postoperative pain severity and analgesic use ( p > 0.05). It may be concluded that addition of ondansetron to paracetamol would not result in further postoperative pain reduction and additive use of this drug is not recommended.

Effect of anesthesia with propofol plus remifentanil vs etomidate plus remifentanil on respiratory function and stress in elderly patients with esophageal leukoplakia treated by gastroscopy

BACKGROUND

With the development of society and the advancement of science and technology, the patient's requirements for comfort during gastroscopy are constantly increasing, and more attention has been paid to the possible adverse reactions. More and more patients choose to undergo painless gastroscopy. Elderly patients have vascular tolerance, significant organ function decline, and higher requirements for anesthetic drugs due to age and degenerative changes. Therefore, it is important to choose the correct anesthetic drugs during gastroscopy in elderly patients.

AIM

To compare the effects of anesthesia with propofol plus remifentanil and etomidate plus remifentanil on respiratory function and stress in elderly patients with esophageal leukoplakia.

METHODS

A total of 200 elderly patients (aged 62-73 years) with esophageal leukoplakia who underwent painless gastroscopy at the Endoscopy Center of our hospital from April 2018 to October 2018 were enrolled. The patients were randomly divided into either a control group or a study group, with 100 patients in each group. The control group was anesthetized with propofol and remifentanil, and the study group was anesthetized with etomidate and remifentanil. Serum oxygen saturation (SPO₂) and stress hormones (adrenocorticotropic hormone, glucocorticoid, and angiotensin) before and at the end of treatment were compared between the two groups. Hemodynamics during treatment, adverse reactions during treatment, and the difference in time to recovery of spontaneous breathing time were also compared.

RESULTS

Serum levels of stress hormones in the two groups were comparable before treatment. At the end of treatment, serum levels of stress hormones (adrenocorticotropic hormone, glucocorticoid, and angiotensin) in the study group were significantly lower than those in the control group (P < 0.05). Hemodynamics was more stable in the study group (P < 0.05). SPO₂ was significantly higher in the study group than in the control group (P < 0.05). The rate of adverse reactions was significantly reduced in the study group (P < 0.05). However, the time to recovery of spontaneous breathing was significantly shorter in the control group than in the study group (P < 0.05).

CONCLUSION

Compared with anesthesia with propofol plus remifentanil, etomidate plus remifentanil in elderly patients with esophageal leukoplakia can reduce inflammatory factors and stress hormones more significantly, maintain hemodynamics and intraoperative blood oxygenation saturation more stably, and have fewer adverse reactions, but is associated with longer time to recovery of spontaneous breathing.