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Abstract
The aim of this study was to assess the effect of a course of dexamethasone on postoperative pain and morbidity after adult tonsillectomy. We report the results of a double-blind, randomized, placebo-controlled trial of 200 adult patients undergoing elective tonsillectomy. Patients were randomized to three groups: one group received the non-steroidal anti-inflammatory drug piroxicam for 8 days postoperatively, one group received dexamethasone for the same period and the third group received both drugs. Patients recorded their pain scores and analgesic requirements daily for 10 days. Patients treated with a combination of piroxicam and dexamethasone recorded consistently lower pain scores than those treated with either drug alone. This difference was statistically significant (P < 0.05) on all days except the day of surgery and the second postoperative day. Patients treated with piroxicam alone had significantly higher analgesic requirements than in either of the other groups. Dexamethasone given in this regime reduces postoperative pain and analgesic requirements after adult tonsillectomy.
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Affiliation(s)
- R Stewart
- Department of Otolaryngology, Craigavon Area Hospital, Northern Ireland
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2
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Abstract
We studied the influence of the timing of injection of bupivacaine into the vas deferens on the intensity and duration of scrotal pain following vasectomy. Forty-two patients undergoing vasectomy under general anaesthesia were randomly allocated to have the operation performed on either the left or the right side first. On the first side to be operated upon, 5 ml bupivacaine 0.5% was infiltrated along the line of the scrotal incision. The vas deferens was identified and 1 ml bupivacaine 0.5% was injected into its lumen, with 0.5 ml directed proximally and 0.5 ml directed distally. After completion of the procedure on that side, the operation continued on the other side. On this occasion, the same dose of bupivacaine was injected into the vas deferens after division and ligation, and subcutaneously along the scrotal incision after skin closure. Median [interquartile range] visual analogue pain scores on the first side to be operated upon were significantly lower than on the second side on day 1 (7 [1.5-19] vs. 11 [2.5-47]) (p < 0.01) and day 7 (0 [0-8.5] vs. 0 [0-18.8]) (p < 0.05) postoperatively. The median [interquartile range] duration of postoperative discomfort was less on the first side operated upon than on the second (3 [1-7] vs. 6 [2-7]) (p < 0.01). Although statistically significant differences occurred between the treatment groups, the actual differences were small and may not be clinically significant.
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Affiliation(s)
- P McConaghy
- Department of Anaesthesia, Lagan Valley Hospital, Lisburn, Northern Ireland
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5
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Cullinane A, Coca-Prados M, Harvey B, O’Reilly C, Ryan MP, Maguire D, O’Sullivan G, Harvey BJ, Gebruers EM, Hall WJ, Harris AM, O’Halloran KD, Curran AK, Bradford A, Bunting HE, McConaghy P, McLoughlin C, Sweeney D, Hardiman O, Grealy M, Sreenan JM, Gilmartin L, O’Cuinn G, Lawlor M, O’Boyle KM, Farrell CB, Foster NEL, Walsh DM, Baxter GD, Allen JM, Cawley T, Breslin E, Docherty JR, Hynes AC, Kane MT, Duffy C, Mohd Nor A, Johnson AH, Tomkin GH, Collins PB, Crónín DÓ, McCloskey S, Thornbury KD, O’Rourke M, Kearns S, Campion DP, Leek BF, Curran AK, Curran AK, O’Regan RG, McLaughlin N, Curran AK, Gaffney J, Edgell TA, Walker JM, MacSweeney CP, Faherty C, Kelly JP, Leonard BE, Earley B, O’Neill M, Reymann JM, Allain H, Caldwell M, Jennings M, Prosser E, Urbach V, Horwitz E, Horwitz ER, Presser E, Raffin JP, Thomas S, Egan DA, O’Farrell A. Royal academy of medicine in Ireland section of biomedical sciences Proceedings of Summer Meeting held June, 1994. Ir J Med Sci 1995. [DOI: 10.1007/bf02968123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Abstract
We have assessed tracheal intubating conditions in 60 ASA I or II children, aged 3-12 yr, after induction of anaesthesia with alfentanil 5, 10 or 15 micrograms kg-1, followed by an induction dose of propofol. Neuromuscular blocking agents were not given. Three aspects of intubating conditions were assessed on a four-point scale: ease of laryngoscopy, vocal cord position and degree of coughing on insertion of the tracheal tube. The number of patients in whom each component of the assessment was satisfactory increased significantly as the dose of alfentanil increased (ease of laryngoscopy P = 0.003; vocal cord position P = 0.0004; degree of coughing P = 0.018). Intubation was successful in 70%, 95% and 95% of patients after alfentanil 5, 10 or 15 micrograms kg-1, respectively, and conditions were considered to be excellent in 20%, 70% and 80% of patients, respectively. Side effects included pain on injection of propofol (27%), excitatory movements (5%) and bradycardia (1.7%).
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Affiliation(s)
- P McConaghy
- Department of Anaesthetics, Belfast City Hospital
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