Mean Pain Score In Group Research Articles

Evaluation of Post-Operative Pain Subsequent to Endodontic Treatment Utilizing Hand and Pedoflex Rotary files in Primary Mandibular Molars: A Clinical Investigation

Aim: To comparatively evaluate postoperative pain levels following root canal instrumentation with hand files versus Pedoflex rotary files in primary mandibular molars. Material and Methods: This randomized clinical trial involved 60 children aged 6-10 years with primary mandibular molars requiring pulpectomy. They were divided into two groups: Group I received hand K file instrumentation, and Group II was treated with Pedoflex rotary files. Pain levels were recorded using the Wong-Baker FACES Pain Rating Scale at 6, 12, 24, 48, and 72 hours postoperatively. Results: The Pedoflex rotary file group experienced significantly lower pain scores at all time intervals compared to the hand K file group (p<0.05). The mean pain score in Group A gradually decreased from 6 to 72 hours, while Group B showed a more rapid decline in the first 24 hours followed by a plateau. Conclusion: The use of Pedoflex rotary files for root canal instrumentation in primary mandibular molars significantly reduces postoperative pain when compared to conventional hand files. These findings suggest that rotary files may provide a more comfortable postoperative experience for pediatric patients undergoing pulpectomy

Comparative Evaluation of the Anesthetic Efficacy of Needle-Free Anesthesia and Conventional Anesthesia in Patients With Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.

Introduction Pain is the primary reason for which most of the patients seek endodontic treatment. Local anesthesia is considered to be the most important step in the procedure to reduce the pain. However, the majority of the patients do not cooperate due to the fear of syringe anesthesia. The aim of this clinical trial was to compare the anesthetic efficacy of needle-free anesthesia and conventional anesthesia in patients with symptomatic irreversible pulpitis undergoing root canal therapy. Materials and methods A total of 54 patients were enrolled in the study, and the treatment was administered by a single operator. The initial assessment of vitality included cold testing, heat testing, and electric pulp testing. Preoperative pain was assessed using the Visual Analog Scale (VAS) before the administration of anesthesia. Local anesthesia was administered according to the group assigned: Group 1 (conventional anesthesia) and Group 2 (needle-free anesthesia). The pain was assessed during the administration of anesthesia. Following the administration of anesthesia, the vitality of the tooth was evaluated using cold testing, heat testing, and electric pulp testing. Subsequently, the tooth was isolated with a rubber dam, and the access cavity was prepared. The pain was assessed during access cavity preparation and during the first file insertion. Working length was determined using an apex locator (Root ZX Mini, J Morita, Saitama, Japan) and was confirmed using intraoral periapical radiographs. Later on, further treatment was carried out. Results A total of 54 participants were included in this clinical trial. There was no significant difference in mean age distribution between the two groups (p=0.852). Considering the frequency distribution of gender, there was no significant difference; however, Group 1 had more female participants (59.3%) compared to Group 2 (33.3%). There was a significant reduction in the mean pain score in Group 2 compared to Group 1 during the delivery of anesthetic agents (p=0.000). Conclusion Needle-free anesthesia proves to be equally effective as the conventional syringe system in patients experiencing symptomatic irreversible pulpitis undergoing root canal treatment. However, it is noteworthy that patients exhibited greater comfort levels with needle-free anesthesia systems specifically during the administration of the anesthetic solution.

Effect of Occlusal Reduction on Alleviating Pain in Symptomatic Apical Periodontitis

OBJECTIVE: To evaluate pain relief in response to occlusal reduction in teeth with symptomatic apical periodontitis METHODOLOGY:A randomized controlled trial was done at department of Operative Dentistry and Endodontics, PIMS Hospital, Islamabad, Pakistan 27th May 2019 to 30th May 2020 on 166 patients suffering from irreversible pulpitis with symptomatic apical periodontitis were included in the study. After consent, Visual Analogue Scale (VAS) was used to document preoperative pain levels. Pulpectomy was done and patients were randomly divided into Group A (without occlusal reduction) and Group B (with 1-1.5mm occlusal reduction). Mean pain scores of Group A and Group B were compared at 24hrs, 72 hours and seventh day using T-test RESULTS: There was a significant difference in mean pain score (p=0.0001) post-pulpectomy between the teeth with and without occlusal reduction. CONCLUSION: The teeth that underwent occlusal reduction after pulpectomy showed lower mean pain levels compared to the non-reduction group. KEYWORDS: Occlusal reduction, apical periodontitis, irreversible pulpitis, pulpectomy, root canal therapy

The Effect of Penile Block Application on Pain Control in Cystoscopy

Cystoscopy is a very effective diagnostic and follow-up method used during many urological procedures. Although the pain has decreased with the frequent use of the flexible cystoscope recently, it is a really uncomfortable method for some patients. In this study, we aimed to investigate the effect of penile block application on pain control during cystoscopy. In this study, the files of 157 male patients who underwent rigid cystoscopy for various reasons between March 2017 and June 2019 were retrospectively scanned. The patients were divided into two groups; those who underwent penile block and those who did not. A visual analog scale was used in all patients to evaluate pain levels. Group I contained 87 and Group II contained 70 patients. The mean pain score in Group I was higher (4.40±0.782) than that in Group II (1.84±0.681) this difference was statistically significant (p=0.032). The use of urethral lidocaine along with penile block has been shown to minimize pain during cystoscopy and increase the tolerability of this procedure.

COMPARISON OF INTRAVENOUS LIGNOCAINE, TRAMADOL, AND KETOROLAC FOR ATTENUATION OF PROPOFOL INJECTION PAIN

Aims: This study aims to study and compare the efficacy of lignocaine, tramadol, and ketorolac in minimizing propofol injection pain. Methods: This is a randomized control research that was conducted on 100 patients between the ages of 18 and 60 years at the department of anesthesiology and critical care. Being planned for elective surgery under general anesthesia with propofol as an inducing drug, with an ASA grade I or II body mass index of 19–30 kg/m2. Each of the four groups of 25 patients was randomly selected from among all the patients. Results: The incidence of pain was 20% in the lignocaine group and 28% in the groups treated with tramadol and ketorolac. 92% of patients in the normal saline group felt discomfort during the propofol injection. In comparison to group N (7.46±2.78), the mean pain score in groups L (0.80±1.32), T (0.98±1.70), and K (1.49±1.55) was statistically significant (p<0.0001). Group N saw noticeably less side effects than the other groups. Statistics showed that groups L, T, and K were comparable. Conclusion: We recommend the use of these agents as pre-treatment to propofol to increase the patient acceptability of this ideal anesthetic agent.

Comparison of the Sedative Effects of Intravenous Midazolam with Intravenous Dexmedetomidine and Duration of Spinal Anesthesia with Bupivacaine During Cesarean Section: A Randomized Double-Blinded Trial

Background: Caesarean section (CS) is a common procedure, and spinal anesthesia is a safe method for inducing anesthesia during this procedure. The disadvantages of this technique are intraoperative pain sensation, the patient’s fear of injection, and remembering surgery. Objectives: The purpose of this study was to compare the effects of intravenous midazolam with intravenous dexmedetomidine on sedation and duration of spinal anesthesia during CS. Methods: In this study, 70 parturients with ASA II were randomly divided into two groups of 35. All parturients underwent spinal anesthesia. One of the groups (i.e., group D) received intravenous dexmedetomidine, and for the other group (i.e., group M), midazolam was injected intravenously. The parturients were compared in terms of the pain score measured by visual pain scoring (VAS), duration of anesthesia, sedation, and hemodynamic stability. Results: The mean pain score in group M was significantly higher than in group D (P < 0.001). The time to the first rescue analgesia was significantly higher in group D than in group M (P < 0.001). Also, the dose of the analgesic used in the postoperative period was significantly lower in group D (P < 0.001). No significant difference was found between the two groups in terms of sedation and hemodynamic status. Conclusions: The use of dexmedetomidine in comparison with midazolam resulted in longer bupivacaine-induced spinal anesthesia and duration of analgesia during and after CS, suggesting this method as an appropriate strategy for establishing an appropriate level of intraoperative sedation in parturients undergoing CS. Neither dexmedetomidine nor midazolam caused significant hemodynamic changes.

Comparison Of Inter-Appointment Pain Between Calcium Hydroxide Mixed With Normal Saline And Calcium Hydroxide Mixed With 2% Chlorhexidine During Root Canal Treatment

Introduction: Pain is one of the major and common symptoms a patient goes through during root canal treatment (RCT). Calcium hydroxide [Ca(OH)2] combined with normal saline (NS) is commonly used as an intracanal medicament against root canal pathogens, but combination of Ca (OH)2 with chlorhexidine (2% CHX) is not routinely used. Aim of this study is to compare the combination of Ca(OH)2 +NS and Ca(OH)2 +2% CHX to reduce the interappointment pain in RCT. Methods: A comparative, prospective, qualitative study was conducted in the Department of Conservative Dentistry and Endodontics, KIST Medical College and Teaching Hospital from September 2022 to March 2023. Total of 60 patients aged 16-70 years were included in the study. Group I received Ca(OH)2+NS and group II received Ca(OH)2 +2% CHX. Pain score was recorded using visual analogue scale (VAS) from baseline to 6,12,24 and 48 hours. Results: The mean pain score after 6 hours for Group I was 0.93(±0.83) and Group II was 1.43 (±0.63); P=0.011. The mean pain score after 12 hours for Group I was 0.40(±0.56) and Group II was 0.90(±0.66); P=0.003. 24 hours, mean pain score for Group I was 0.27(±0.45) and Group II was 0.60(±0.56); P=0.014. Patients reported reduction of pain after 24 hours, with Ca(OH)2 +NS (Group I) than Ca(OH)2 +2% CHX (Group II). Conclusion: The combination of Ca(OH)2 +NS was more effective in reducing interappointment pain than Ca(OH)2 +2%CHX.

Ultrasound-guided supraclavicular brachial plexus block versus intravenous opioid-tramadol in providing pain relief to patients presenting with upper limb injuries to the emergency department

Introduction: Pain is the most common complaint in patients presenting to an emergency department (ED). Providing safe and effective pain management is an essential part and primary goal of initial ED management. It can be challenging, especially with a significant injury such as a humerus fracture or any long-bone injury. The movement of patients to get X-rays or transfer to a special bed can cause additional pain. Patients experiencing greater pain will more likely require extended hospital stays, be slower to mobilize, and experience a lower quality of life-related to their health. Aim and Objectives: 1. This study aimed to compare the efficacy of ultrasound-guided supraclavicular brachial plexus block and intravenous tramadol in relieving pain in patients with isolated upper limb injuries who are presented to the ED. 2. To study the efficacy and safety of ultrasound-guided supraclavicular brachial plexus block for the management of pain caused due to upper limb injuries in ED. Methods: A total of 40 patients with isolated upper extremity closed injuries (dislocations and fractures) who were presented to ED were investigated in this study. Eligible patients were asked to choose USG-guided SCB or intravenous tramadol treatment for pain management. For their initial analgesia, participants in Group A were given ultrasound-guided supraclavicular brachial plexus block, while Group B received 50 mg intravenous tramadol for over 10 min. After the treatment, patients were assessed for pain relief at 0 min, 15 min, 30 min, and 1 hour in both groups, and their vitals and pain score were recorded. The duration of pain relief, complication, and usage of rescue drugs was recorded, and the efficacy of both methods was compared. All patients were investigated with an X-ray or CT scan (if required) to confirm their diagnosis. Clinical information was recorded for 60 minutes, and patients were discharged or admitted. Results: Of the patients who were presented with upper extremity injuries, only 40 were enrolled in this study. USG-guided SCB was performed on Group A (n = 20) patients. Alternatively, Group B (n = 20) patients received intravenous tramadol 50 mg. In Group A, female patients were higher in number. In contrast, the opposite was noted in Group B. Road traffic accidents was considered the most common way of causing injury, and the most common injury was fractures. The shoulder was more commonly injured than the other parts. The mean pain score in Group A patients on arrival was 8.2, while that of Group B patients was 7.1. After the therapy, the mean pain score in Group A was drastically reduced to 2.9; in Group B, it was reduced to only 4.45. Further, the requirement for additional analgesics was higher in the tramadol group than in the ultrasound-guided supraclavicular block group. 23 out of 40 patients were admitted for further care and management. Conclusion: In patients with upper limb injuries to the ED, ultrasound-guided supraclavicular block can provide better pain relief and be more efficacious than parenteral tramadol treatment.

DOES INFILTRATION OF LOCAL ANESTHESIA IN THE POSTERIOR CAPSULE REDUCES PAIN IN TOTAL KNEE REPLACEMENT WHEN COMPARED WITH PLACEBO

The current analysis aimed to determine the mean pain score after injecting long-acting local anesthesia in the posterior capsule after a total knee replacement by comparing it with the placebo group. This prospective cohort study was conducted in the orthopedic department of Aziz Bhatti shaheed teaching hospital Gujrat from 1st June to 31st December 2022. The mean pain score was assessed at the end of 24 hours after postoperative surgery and measured by a visual analog scale (VAS = 0-10) where 0 was taken as no pain and 10 as worst pain. We divided cases into groups A and B. Group A was given a drug, and Group B was given normal saline. The knee pain score was calculated at the end of 24 hours postoperatively. Out of 222 patients, (47.30%) were male and 117(52.70%) were female, with ages ranging from 40 to 70 years; in group A, the mean age was 58.29±6.84 years and 58.39 ±7.33 years in group B. The mean BMI was 30.55±2.46 kg/m2. In group A, 52 (46.85%) patients had DM, while 49 (44.14%) were in group B. The mean pain score in group A was 2.95±0.98 and 4.44±1.13 in group B with p-value =0.0001. Stratification of pain score was performed concerning age, gender BMI and DM. Statistically significant results were found among age and gender. This study concluded that there is less mean pain score after long-acting local anesthesia in posterior knee capsules compared with placebo in total knee replacement.

Effect Of Flippits Versus Virtual Reality On Pain, Fear, And Satisfaction During Phlebotomy Among Children.

To determine the effect of flippits versus virtual reality on pain, fear and satisfaction among children during phlebotomy. The quasi-experientialstudy was conducted at the Paediatric Medical Department of Kafrelsheikh University Hospital, Egypt, from November 2021 to April 2022, and comprised children of either gender aged 6-12 years. The subjects were randomised into flippits group A, virtual reality group B and control group C in which only traditional care was provided. Data was collected using a structured interview, Wong-Baker Faces Pain Rating Scale, Children's Fear Scale, and Blood Specimen Collection Satisfaction Evaluation Scale. Data was analysed using SPSS 20. Of the 120 children, 40(33.3%) were in each of the three groups. There were 21(52.5%) boys and 19(47.5%) girlsin group A with mean age 8.2±1.6 years, 22(55%) boys and 18(45%) girlsin group B with mean age 7.8±1.7 years, and 27(67.5%) boys and 13(32.5%) girls in group C with mean age 7.9±1.9 years (p>0.05). Mean pain and fear scores were significantly lower and mean satisfaction score was higher in groups A and B than group C (p<0.05). There was no significant difference in the mean pain scores of group A and group B (p>0.05). Flippits and virtual reality interventions had a positive effect on pain, fear and satisfaction levelsin children during phlebotomy.

Comparative evaluation of temporal fascia and dermal fat graft in the management of temporomandibular joint ankylosis.

Temporomandibular joint (TMJ) ankylosis is a debilitating condition usually afflicting children and young adults, causing long-term functional, aesthetic, and severe psychological impacts on the lives of these patients. To compare the postoperative outcomes after using one of the most commonly employed inter-positional graft, i.e., temporalis fascia, and a recently introduced 'more suitable' graft, i.e., dermal fat. A prospective study in which 20 patients of TMJ ankylosis were randomly assigned into two groups of 10 patients each. Temporalis fascia was used as an inter-positional graft in one group, while dermal fat graft was used in the other group. Post-surgical clinical parameters were evaluated, including interincisal mouth-opening and pain. Interincisal mouth opening at six months was greater in group A (32.1 ± 12.93) as compared to group B (33.8 ± 4.89), but statistically, it was not significant (P = 0.478). The mean pain score in group A was 4.60 ± 1.17, 1.50 ± 0.70, 0.20 ± 0.42 on day 1, 7, and 15, respectively. The mean pain score in group B was 4.10 ± 0.99, 1.30 ± 0.48, 0.20 ± 0.42 on day 1, 7, and 15, respectively. Both the graft materials work well in terms of maximum interincisal opening. For more clarification, a larger sample size with a longer duration of follow-up is needed to validate the study.

A COMPARATIVE STUDY BETWEEN CAUDAL ROPIVACAINE AND ROPIVACAINE PLUS DEXAMETHASONE FOR INFRAUMBILICAL SURGERY IN PEDIATRIC PATIENTS

Background: Caudal block is one of the most popular regional block in children with high success rate for infra-umbilical surgeries. Among local anaesthetics ropivacaine provides a greater margin of safety, less motor blockade, less neurological and cardiac toxicity and similar duration of analgesia compared to bupivacaine. Addition of dexamethasone as an additive to local anesthesia decreases the postoperative rescue analgesia consumption.This study was designed to compare the effectiveness of intra-operative and postoperative analgesia on adding dexamethasone to 0.15% ropivacaine with 0.15%ropvacaine given alone. A prospective double blinded Materials: randomised controlled study was conducted consisting of 60 patients undergoing infra-umbilical surgeries under general anesthesia with Caudal block. Patients were randomised into two groups. Group A received 0.15% Inj.ropivacaine 1.5ml/kg with 1ml normal saline and Group B received 0.15% Inj.Ropivacaine 1.5ml/kg with 0.1mg/kg Inj.dexamethasone in caudal block Results: Mean FLACC pain score was comparable and statistically not signicant (P=0.083) in both groups upto 30min postoperatively. At 60min mean pain score in group A was 0.30 ± 0.54 and in group B was 0 (P=0.005) which was statistically signicant. In group A 40%(12) patients required rescue analgesia whereas in group B only 10%(3) patients required analgesia(P= 0.007) Patients remained hemodynamically stable throughout the procedure. After 60min Conclusion: postoperatively FLACC score was signicantly higher in group A as compared to group B. It concludes that addition of dexamethasone signicantly reduced postoperative pain and need for rescue analgesia without any side effects.

Comparison of outcome in fistulectomy and Ligation of intersphinteric tract in patients of fistula in ANO.

Objective: To compare fistulectomy and ligation of inter sphincteric tract in patients of fistula in ano in terms of postoperative pain and duration of wound healing. Study Design: Prospective Experimental study. Setting: Department of General Surgery of Faisalabad Medical University and Affiliated Hospitals. Period: 22-01-2021 to 21-07-2021. Material &amp; Methods: Computer-generated random numbers were used to assign the type of treatment (group. A or B). Group A patient underwent treatment with fistulectomy. Group B patient underwent treatment with ligation of inter sphincteric tract (LIFT). Post-operative pain was noted and scored at 12, 24 and 48 hours and after one week on visual analogue scale (VAS). Healing time noted in both groups and patients followed up for 5 months. Results: Out of these 60 study cases, 46 (76.7 %) were male patients while 14 (23.3 %) were female patients. Mean age of our study cases was 43.17 ± 10.77 years. Mean pain score in group A was noted to be 4.77 ± 0.858 while that of group B was noted to be 3.07 ± 1.01 (P&lt;0.001). Mean duration of wound healing in group A was 7 weeks and in group B was 3 weeks(P&lt;0.001). Conclusion: Ligation of inter-sphincteric tract is better than fistulectomy in patients of fistula in ano as it is associated with significant reduction of pain and duration of wound healing.

Uterin Fibroid Embolizasyon İşleminde Kullanılan Mikroküre Boyutunun Tedaviye Etkilerinin Retrospektif Analizi

Giriş: Uterin fibroidlerin tedavisinde altın standart yöntem minimal invaziv uterus koruyucu cerrahilerdir. Uterin fibroid embolizasyonu işlemi yaklaşık 20 yıldır uygulanmaktadır. Embolizan ajan olarak kullanılan mikroküre boyutlarının UFE tedavisine etkileri retrospektif olarak araştırılmıştır. &#x0D; Gereç ve Yöntemler: Retrospektif çalışmamızda UFE uygulanan 44 hastadan 500 Mikron ve altı boyutta mikroküreler ile tedaviye başlayan hastalar (Grup 1) ile 700 Mikron ve üstü mikroküre kullanılan hastaların (Grup 2) sonuçları karşılaştırıldı. Ağrı skorlaması, semptomlar ve dominant fibroid volümü işlem öncesi ve UFE sonrası 6. ay sonuçları karşılaştırıldı. &#x0D; &#x0D; Bulgular:Çok ciddi ağrı ve ciddi ağrı skorlayan hastaların sayısı Grup 1’de daha fazladır. Grup 1 ortalama ağrı skoru 4,9 iken Grup 2’de bu skor 3,6 bulundu(P

Comparison of mean Postoperative Inguinodynia in patients undergoing open Inguinal Hernia Surgery with use of standard Polypropylene Heavy Weight Mesh v/s Ultra Pro light Weight Mesh

Background: Various types of meshes for inguinal hernias have been discovered to combat with chronic groin pain related problems. The data regarding these findings was variable due to difference in the cut off values used in the past in different studies to label inguinodynia and local data was scarce where HWM is still highly practiced. Aim: To compare the mean postoperative inguinodynia in patients undergoing open inguinal hernia surgery with use of standard polypropylene heavy weight mesh (HWM) v/s Ultra Pro lightweight mesh (LWM). Methodology: This is a prospective randomized controlled trail conducted at department of surgery, Services Institute of Medical Sciences, from July 2019 to June 2020. Cases were divided in two groups by using radio opaque sealed envelopes labeled as A and B. Group-A underwent Lichtenstein mesh repair by Ultra Pro LWM and group B had polypropylene heavy weight mesh (HWM). Lichtenstein mesh repair was done under spinal or general anesthesia by the experienced surgeon. Duration of surgery was also calculated (from incision to closure). Patient was followed in outpatient department at 3 months where the outcome was seen and inguinodynia was assessed. Results: The mean age was in group A was 40.66±10.52 years and 40.53 ±12.56 years in group B. The mean pain Score in group A was 2.024±0.88 and in Group-B it was 2.97 ±0.85. Conclusion: Ultra Pro LWM is more effective in terms of less postoperative pain as compared to standard polypropylene heavy weight mesh in patients undergoing open inguinal hernia surgery Keywords: Postoperative, Inguinodynia, Inguinal hernia, Standard, Polypropylene heavy weight mesh, Ultra Pro light

Compare the Efficacy and Safety of SAPB with Continuous Tea in Patients Undergoing Open Lung Resection

Objective: Serratus anterior plane block (SAPB) combined with continuous thoracic epidural analgesia (TEA) is the primary goal of our research. Study Design: Randomized Controlled Trial Place and Duration: Conducted at M.Islam Medical College Gujranwala/Rashid Latif Medical College Lahore, during from June 2021 to Dec 2021. Methods: There were one hundred and six patients of both genders were presented in this study. Patients were aged between 18-65 years.After obtaining written agreement, the demographics of enrolled patients were recorded, including their age, gender, and BMI.Patients were underwent for elective thoracotomy for lung cancer surgery. Patients were equally divided into two groups. A thoracic epidural catheter (10 ml levobupivacaine 0.25 percent followed by 5 ml/hour of 0.125 percent) was given to group II, and a SAPB (30 ml levobupivacaine 0.25 percent followed by 5 ml/hour of 0.125 percent) was given to group I. In order to assess pain, the researchers utilized a visual analogue scale (VAS). The post-operative results of both groups were compared to each other. The full data set was analyzed using the SPSS 24.0 edition. Results:We found majority of the patients 66 (62.3%) were males and 40 (37.7%) cases were females with mean age 50.2±4.42 years. Mean body mass index of the cases were 24.7±6.33kg/m2. In both groups majority of the patients 35 (66.03%) and 36 (67.9%) had ASA class III. Mean operative time in group I was greater 132.8±8.75 minutes as compared to group II 124.3±9.55 minutes. Mean pain score in group I was lower 40.6±5.21 as compared to group II 65.3±4.31. Mean VAS time of coughing was greater in group II of 76.7±1.44 than that of group I 66.2±7.37 cm•h. Analgesic usage was significantly reduced in group I, and the incidence of nausea and vomiting was significantly reduced, with no change in the rate of hypotension between the two groups. Conclusion: In this trial, we found that continuous SAPB was more effective than TEA in reducing postoperative pain in patients following open lung resection for cancer, andcomplications were reduced in the SAPB group. Keywords: Open Lung Resection, Analgesia, SAPB, TEA, VAS

Transversus Abdominis Plane Block Versus Local Anesthetic Wound Infiltration for Postoperative Analgesia in Adult Patients Undergoing Hernia Repair in Daycare Procedure: A Randomized Control Trial.

Introduction: Various modalities are now being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic non-steroidal anti-inflammatory drugs. This study compared the mean postoperative pain score between ultrasound-guided transversus abdominis plane (TAP) block and a local anesthetic wound infiltration at the surgical incision site.Methodology: A prospective, comparative, randomized controlled trial (RCT) was carried out from February 2021 to September 2021. The study was conducted in the anesthesia department of Dow University of Health Sciences, Karachi, Pakistan. Patients aged 18-80 years presenting with elective surgery of (both direct and indirect) inguinal hernia repair were enrolled in the study. Participants were randomly assigned into one of the two groups that are local anesthetic wound infiltration (Group A) and TAP block (Group B). The mean pain score was assessed using a visual analog scale and compared between the two groups.Results: The study included 168 patients grouped in two different groups. The mean age in Group A was 43.87 (+17.21), and Group B was 47.01 (±15.37). Mean pain scores in groups A and B were 6.36±1.94 vs 4.51 ± 1.99 (p-value=0.001). The pain rescue medications were given to 57.14% of patients in Group A and 34.52% of patients in Group B, and it was significantly different in the two groups (p-value=0.003). It was found that patients in Group A reported more severe pain (41.67%) than patients in Group B (10.71%).Conclusion: When compared to local anesthetic wound infiltration, ultrasound-guided TAP block had better analgesic activity compared to local anesthetic wound infiltration.

EFFECT OF SINGLE-DOSE PREGABALIN ON POSTOPERATIVE PAIN IN DACRYOCYSTORHINOSTOMY SURGERY

Objective: To evaluate the analgesic potential of pregabalin in ambulatory dacryocystorhinostomy surgeries under general anaesthesia.&#x0D; Study Design: Quasi-experimental study.&#x0D; Place and Duration of Study: Tertiary Care Hospital Rawalpindi, from Nov 2019 to Sep 2020.&#x0D; Methodology: A total of 110 patients undergoing ambulatory dacryocystorhinostomy surgery at our hospital were included in the study. Participants were divided into two groups, group A (n=55) were administered 150 mg oral pregabalin, while a placebo was given to participants of group B (n=55). Post-operative pain was assessed at recovery, four and eight hours after surgery with the help of the visual analogue scale.&#x0D; Results: Mean age of participants was 43.05 ± 7.5 years. Gender wise distribution showed 62 (56.4%) males and 48 (43.6%) females. At recovery, four and eight hours after surgery the mean pain scores in group A (pregabalin) vs group B (placebo) were (2.98 ± 0.8 vs 4.98 ± 0.8, p&lt;0.001, 2.67 ± 0.6 vs 5.02 ± 0.8, p&lt;0.001 and 1.49 ± 2.9 vs 2.95 ± 0.8, p&lt;0.001 respectively). Opioid administration frequency in trial versus placebo group was [11 (20%) vs 32 (58.2%), p&lt;0.001].&#x0D; Conclusion: Pregabalin has analgesic potential moreover decreased postoperative consumption of opioids and associated adverse effects such as nausea and vomiting. Hence making it a suitable agent for pain relief in ambulatory surgeries.

Intravenous analgesia versus thoracic epidural catheterization in moderately severe pancreatitis: A randomized controlled trial in a tertiary care health facility.

Objective: In this study we evaluated the two most commonly used methods for pain relief in acute pancreatitis i.e. epidural analgesia and I/V analgesia and compared the results. Study Design: Randomized Controlled Clinical Trial. Setting: Surgical Unit-1 of Holy Family Hospital, Rawalpindi. Period: June 2019 to June 2020. Material &amp; Methods: Patients presenting with acute pancreatitis with moderate severity were divided into groups A and B. In group A patients, epidural catheter was passed at T9-T10 level epidural space and they received 0.125% Bupivacaine injection every 4 hours, while group B patients received combination analgesia in the form of IV tramadol 100mg TDS and IV Toradol 30mg BD. Pain was assessed by using visual analog scale (VAS) at 12 hour intervals. Rescue analgesia, in the form of IV paracetamol 1g given in the case of &gt;7 VAS score was also recorded. Results: Total 100 patients were included according to the inclusion criteria of the study. Patients were randomly divided into two groups; Group A (Epidural) and group B (intravenous). Mean age (years) in the study was 42.39+11.21 whereas there were 37 male and 63 female patients who were included in the study. In our study, mean pain score in group A was 3.16+1.23 which was significantly lower than group B (5.42+1.01), p-value &lt; 0.0001. There was a single mortality in the study. 6 patient’s required ventilatory support due to respiratory complications, 5 in group B and 1 in group A. Conclusion: Epidural analgesia is superior to I/V analgesics in pain management of moderately severe pancreatitis and it also reduces respiratory morbidity in these patients.

Compare the Outcomes of Subcutaneous Drains versus No Drains in Patients with Repeated Cesarean Section

Objective: The aim of this study is to compare the outcomes of subcutaneous drains versus no drains in patients with repeated cesarean section. Study Design: Randomized control trial Place and Duration: Conducted at Gyne &amp; Obs Department, Shahida Islam Teaching Hospital Lodhran, during from 8-01-2020 to 8-08-2020. Methods: Total 90 pregnant women with repeated cesarean section were presented in this study. Patients were aged between 22-50 years. Detailed demographics of enrolled cases including age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were categorized into two groups, group I had 45 patients with subcutaneous drain and 45 patients of group II were without drain. Post-operative outcomes were assessed and compared among both groups. VAS was used to compare pain among both groups. SPSS 22.0 version was used to analyze the data. Results: Mean age of the patient in group I was 30.6±8.44 years with mean BMI 33.08±5.26 kg/m2 but in group II mean age was 29.03±7.37 years with mean BMI 31.12±11.58 kg/m2. Mean gestational age in group I was 37.9±3.9 weeks and in group II mean gestational age was 37.3±2.7 weeks. There was no any significantly difference in parity among both groups. Post-operative mean haemoglobin in group I was lower 7.9±1.6 gm% as compared to group II 8.11±0.4 gm%. Mean pain score in group I was 6.8±4.7 and in group II was 8.2±4.11. Prevalence of wound infection was greater in group II 5 (11.1%) as compared to group I 3 (6.7%). Hospital stay was shorter in group I 9.7±2.11 days as compared to group II 10.8±1.14 days. Frequency of superficial SSI and wound seroma were significantly higher among patients of group II. Conclusion: In this study we concluded that those patients who received subcutaneous drain undergoing cesarean section resulted low post-operative pain with fewer chances of wound infection as compared to the patients undergoing C-section without drain. Except this frequency of SSI and hospital stay was shorter among patients of drain group. Keywords: Cesarean, Drain, Wound Infection, Superficial Surgical Site Infection, Pregnant Women