Journal of the Indian Medical Association
-
Randomized Controlled Trial Comparative Study
Pressor responses following insertion of laryngeal mask airway in patients with controlled hypertension: comparison with tracheal intubation.
The present study was undertaken in patients with controlled hypertension to determine the pressor responses following insertion of laryngeal mask airway (LMA) as compared to endotracheal intubation. Two hundred patients with controlled hypertension of either sex, belonging to ASA II undergoing elective surgical procedures of 11/2 to 2 hours duration, were studied in a randomised manner into two equal groups: A(n =100) and B(n = 100) depending on whether LMA or endotracheal tube was used. General anaesthesia and controlled ventilation was undertaken according to standard procedure. ⋯ Heart rate also increased from baseline value in endotracheal intubation group than in LMA (P<0.05). To conclude insertion of LMA was associated with lesser pressure response as compared to endotracheal intubation in patients with controlled hypertension. It is an effective method to avoid laryngoscopic pressor response during endotracheal intubation in hypertensive patients.
-
Randomized Controlled Trial Clinical Trial
Efficacy of thiocolchicoside in Indian patients suffering from low back pain associated with muscle spasm.
Low back pain (LBP), a high prevalent condition among middle aged population, is usually associated with 'muscle spasm' that is responsible for giving rise to pain as well as its persistence. Muscle spasm is an involuntary, painful contraction of muscles that interferes with the function and cause of muscular disorder. Therefore centrally acting skeletal muscle relaxants, also called lissive drugs, are commonly used for its treatment. ⋯ Patients were followed up on 3rd and 7th day and severity score of various parameters was recorded. There was significant difference among the treatment groups in favour of TC than TZ in efficacy parameters thus showing TC is at slightly better effective than TZ and in case of safety, TC scores significantly better over TZ in the patients with accompanying muscle spasm. These findings confirm that TC is a preferred option for the LBP with muscle spasms.
-
Randomized Controlled Trial Multicenter Study Comparative Study
An open prospective study on postmarketing evaluation of the efficacy and tolerability of diacerein in osteo-arthritis of the knee (DOK).
According to World Health Organisation osteo-arthritis is the second commonest musculoskeletal problem in the world. Diacerein has been recently introduced in India for the treatment of osteo-arthritis. In view of the ulcerogenic potential of NSAIDs and the cardiotoxicity problems associated with COX-2 inhibitors, diacerein has the potential of being a non-ulcerogenic and non-cardiotoxic alternative respectively to NSAIDs and of COX-2 inhibitors in the treatment of osteo-arthritis. ⋯ The severity of the adverse events was mild in all the cases and disappeared with continued treatment. None of the patients dropped out of the study on account of adverse events or lack of efficacy. Thus, in conclusion, the results of the present study in a large population of Indian patients indicates that diacerein constitutes a novel approach to the treatment for the short- and long-term symptomatic management in Indian patients with osteo-arthritis of the knee.
-
Randomized Controlled Trial Comparative Study
A study on the effects of diclofenac sodium and etoricoxib in the treatment of osteoarthritis.
Diclofenac sodium, a non-selective cyclo-oxygenase inhibitor and etoricoxib, a selective cyclo-oxygenase-2 inhibitor have been widely used in treatment of patients with osteo-arthritis. Five hundred and eighty-five patients with uncomplicated knee osteo-arthritis were randomly allocated into 3 equal groups and received either diclofenac sodium, etoricoxib or placebo in a double-blind manner. The response in both the drug groups was comparable and much more than placebo group. The study shows that etoricoxib provides better clinical efficacy and gastro-intestinal tolerability in osteo-arthritis in comparison to diclofenac sodium presumably due to the selective inhibition of cyclo-oxygenase-2 by etoricoxib.
-
Randomized Controlled Trial Clinical Trial
Role of parecoxib in pre-emptive analgesia: comparison of the efficacy and safety of pre- and postoperative parecoxib in patients undergoing general surgery.
Management of acute postoperative pain remains sub-optimal despite the availability of multiple analgesics and improved pain management strategies (with nearly 80 % of patients reporting moderate to extreme pain following surgery). To evaluate the role of parecoxib as a pre-emptive analgesic in patients undergoing general surgery, the present study was undertaken. Eighty patients of either sex, aged 18 to 70 years, requiring elective ambulatory general surgery like hernioplasty, appendicectomy, cholecystectomy, etc, were enrolled in this prospective, randomised, assessor-blind, parallel-group, comparative trial. ⋯ Present results suggested that pre-operative administration of parecoxib was more effective than a postoperative use in providing pain relief in postoperative period in patients undergoing elective general surgical procedures. Both the regimens were well tolerated. Based on the above data, it appears that pre-operative dose of parecoxib 40 mg IV/IM is a useful optionfor pre-emptive analgesia in general surgical practice.