Online ISSN: 2515-8260

Keywords : Visual Analogue Scale


A clinical study of post-operative analgesia with intravenous paracetamol versus dexmedetomidine in patients undergoing laparoscopic cholecystectomy

Dr. Santosh Kumar, Dr. Nandini CV, Dr. Salim Iqbal M, Dr. Renita Lincia, Dr. Harsoor SS

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1431-1435

Pain management, stable hemodynamics and early post-operative recovery are the new challenges in ambulatory surgeries. The literature rates post-operative pain in laproscopic cholecystectomy as mild to severe pain. Our objective is to assess the post-operative analgesia with intravenous paracetamol versus dexmedetomidine in patients undergoing laproscopic cholecystectomy.
Methods: After ethical committee clearance, 60 patients were randomly allocated into two groups after informed consent. Patients between 18-50 years, ASA 1or 2 were included and those on opioids, any anti-inflammatory drugs, and hypersensitivity to study drugs were excluded. Group D received intravenous dexmedetomidine 1μg/kg as bolus over 10 min followed by dexmedetomidine infusion at 0.25ml/kg/h (0.25ml = 0.5μg). Group P received 1 g intravenous paracetamol in 100ml solution of normal saline over 10 min followed by infusion of 0.25ml/kg/h of normal saline.
Results: Demographic parameters were comparable between the groups. Time for first rescue analgesia, and total doses of analgesia in 24 h in group D was 225.33±29.12 and 2.73±0.64 and in group P was 143.33±28.96 and 4.23±0.77 respectively with p value 0.001 which was statistically significant.
Conclusion: Dexmedetomidine loading dose 1μg/kg and maintenance dose 0.5μg/kg is a good anesthetic adjuvant for general anesthesia to reduce post-operative requirement of analgesia in laparoscopic surgeries.

Role of platelet rich plasma in patients with periarthritis shoulder

Dr. Rahul, Dr. Devendrappa H, Dr. Raghavendra, Dr. Yugandhar S

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2404-2414

Introduction: Pain and decreased ROM is a common presenting condition to orthopaedic outpatient department. Primary Frozen shoulder is estimated to affect 3 to 5% of the general population since PRP is an autologous biologic material, it involves a minimum risk of Immune reactions and transmission of infectious and contagious disease. With this we need assess the efficacy of PRP Shoulder.
Aim and Objective: To assess the efficacy of Platelet Rich plasma in periarthritis shoulder.
Methods: This study included 50 patients diagnosed with periarthritis shoulder and were recruited from the outpatient department of orthopaedics, VIMS, Bellary from the period between November 2018 -2020. The study included both sexes. All patients were injected intraarticularly with PRP. They were evaluated by visual Analogue scale (VAS) for pain and a shortened version of disabilities of arm, shoulder and hand using DASH score for function.
Results: Descriptive and inferential statistical analysis has been carried out in the present study Descriptive and inferential statistical analysis has been carried out in the present study using Student ‘t’ test (two tailed, dependent & independent) and Fisher test. The improvement in VAS score and DASH scores at 3rd, 6th and 12th week follow up in patients who received PRP injections was statistically more significant compared to scores at the time of admission as inferred by p value of <0.05. Using Student ‘t’ test (two tailed, dependent & independent) and Fisher test. The improvement in VAS score and DASH scores at 3rd, 6th and 12th week follow up in patients who received PRP injections was statistically more significant compared to scores at the time of admission as inferred by p value of <0.05.
Interpretation & Conclusion: Our study concludes that the efficacy of single injection of platelet rich plasma to relieve the pain of Periarthritis shoulder is effective less-invasive lines of treatment over a short term follow up period. However more studies are required to evaluate the efficacy of PRP over long term with multi centric study & comparison with the current available treatment options.

Multimodal Post-Operative Pain Management Using Intraoperative Periarticular Cocktail Injection In Total Knee Arthroplasties

Dr. Kailash Karur , Prof Nandakumar R , Dr. Santhosh Kumar G , Dr. Sripriya R

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2994-3005

INTRODUCTION: Total knee arthroplasty (TKA) is one of the best methods for end stage osteoarthritis of knee joint that relieves pain and improves joint function. Most important problem which the patient suffers is postoperative pain, which has harmful effects on patient’s rehabilitation. The aim of our study was to assess the postoperative pain relief and functional outcome following use of combination of drugs which we used as intraoperative, periarticular cocktail injection.
MATERIALS AND METHODS: It is a prospective interventional study consisting of 40 TKA’s done in a single unit. All patients underwent TKA under spinal anaesthesia and underwent standard postoperative protocol. Intraoperative periarticular cocktail consisting of Bupivacaine 0.5% (20ml), Adrenaline 0.3 ml (1:1000), ketorolac 30mg/1ml, methylprednisolone 40mg//1ml, cefuroxime 750mg/10ml with 27.7 ml of normal saline to make total of 60ml solution was given. Assessment of pain was done by visual analogue scale (VAS) and functional assessment by knee society score postoperatively. The number of rescue analgesia used was recorded. 
RESULTS: Mean age of patients was 64 years (47-76) with females predominantly affected than males. Mean static VAS at 6 hours was 4.3 and dynamic VAS at 1st recording was 4.9. there was a strong correlation between Body Mass Index and Dynamic VAS at 1st and Dynamic VAS at 3rd   recording with p < 0.05. Patient satisfaction and functional scores improved postoperatively and there was a statistically significant improvement in knee ROM (P< 0.05). only 2 patients received more than 3 doses of rescue analgesia due to high BMI. No complications related to the infiltration of the local anaesthetic were observed.