The Journal of international medical research
-
Randomized Controlled Trial
Efficacy of a multimodal analgesia protocol in total knee arthroplasty: a randomized, controlled trial.
A total of 100 osteoarthritis patients undergoing unilateral total knee arthroplasty were randomly assigned to receive either a multimodal analgesia protocol, comprising oral celecoxib and tramadol before and after surgery and intra-articular injection of large doses of morphine, ropivacaine, adrenaline and betamethasone during surgery (trial group), or oral and intra-articular placebo (control group). All patients received patient-controlled analgesia for 48 h after surgery. ⋯ Active straight leg raise and active 90 degrees knee flexion were achieved sooner and range of knee movement at postoperative days 1 - 15 were significantly greater in the trial group. Postoperative wound healing, infection, blood pressure, heart rate, rash, respiratory depression, urinary retention and deep vein thrombosis were similar in the two groups, but nausea and vomiting were significantly less frequent in the trial group.
-
Randomized Controlled Trial
Short-term effectiveness of ultrasound therapy in knee osteoarthritis.
This randomized, placebo-controlled, double-blind study was designed to investigate the short-term efficacy of ultrasound therapy in 90 patients with knee osteoarthritis (OA). Patients were randomly assigned to three groups: group 1 received continuous ultrasound, group 2 received pulsed ultrasound, and group 3 received a 'sham' (placebo) ultrasound for 5 min each session. All treatments were applied once a day for 5 days a week for 2 weeks, i.e. a total treatment duration of 10 days. ⋯ The reductions in pain and WOMAC scores were significantly higher in patients treated with pulsed ultrasound than in the placebo group. In conclusion, pulsed ultrasound therapy is a safe and effective treatment modality in patients with knee OA. Further research is required to investigate the long-term efficacy of pulsed ultrasound therapy in knee OA.
-
Randomized Controlled Trial
Intraperitoneal ropivacaine for effective pain relief after laparoscopic appendectomy: a prospective, randomized, double-blind, placebo-controlled study.
This prospective, randomized, doubleblind, placebo-controlled study evaluated the effectiveness of intraperitoneal instillation of ropivacaine in the relief of pain in patients undergoing laparoscopic appendectomy. Patients in group C (placebo control group; n = 33) received normal saline and those in group I (instillation group; n = 30) received an instillation of 2 mg/kg ropivacaine at the initiation of the pneumoperitoneum. ⋯ Thus, intraperitoneal ropivacaine instillation reduced pain during the post-operative period after laparoscopic appendectomy. In addition, this drug was easy to administer and had no adverse effects at the dose used.
-
Randomized Controlled Trial
Procalcitonin: a novel cardiac marker with prognostic value in acute coronary syndrome.
Procalcitonin (PCT) is implicated as an inflammatory marker in early atherosclerosis. In order to investigate the clinical consequences of increased PCT levels in acute coronary syndrome (ACS), 77 patients (29 with non-ST-elevation myocardial infarction [MI], 34 with ST-elevation MI and 14 with unstable angina pectoris) were included and followed up for 6 months. ⋯ The PCT levels within 48 h post-admission in the nine patients who died within 6 months were also significantly higher compared with the survivors (0.451 +/- 0.44 versus 0.406 +/- 1.37 ng/ml, respectively). It is concluded that higher PCT levels within 48 h post-admission may reflect an inflammatory state that is associated with increased early and 6-month mortality.
-
Randomized Controlled Trial
Neuromuscular blockade by vecuronium during induction with 5% sevoflurane or propofol.
This randomized trial investigated whether 5% sevoflurane potentiated neuromuscular blockade by vecuronium. General anaesthesia was induced with 5% sevoflurane in oxygen in 16 patients or with propofol in 16 patients. After loss of consciousness, vecuronium was administered to all participants at randomly assigned doses of 25, 30, 35 or 40 μg/kg. ⋯ In both groups, maximum blockade at the corrugator supercilii was significantly less intense than that achieved at the adductor pollicis. In the dose-response analysis, the 50% and 95% effective doses were lower for sevoflurane than for propofol in both muscles, although this did not reach statistical significance. It is concluded that induction of general anaesthesia with sevoflurane might provide improved conditions for intubation and reduce airway problems.