A Cross-Sectional Pharmacoepidemiological Study of the Utilization Pattern of Pre-Anesthetic Medications in Major Surgical Procedures in a Tertiary Care Hospital

Kulkarni, Madhuri; Patil, Anant

doi:10.7759/cureus.1344

Cited by 9 publications

(13 citation statements)

References 13 publications

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“…Its respiratory depression, nausea and vomiting, and other side effects are less than morphine. In recent years, pentazocine has been widely used for postoperative analgesia and cancer analgesia [7]. Ketorolac tromethamine belongs to nonsteroidal anti-inflammatory drugs.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Different Preemptive Analgesia on Postoperative Analgesia, Oxidative Stress, and Inflammatory Response after Gynecological Laparoscopic Surgery

Sun

Yang²,

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To observe and compare the analgesic effects of oxycodone, pentazocine, and ketorolac tromethamine pre-emptive analgesia on gynecological laparoscopic patients after operation and the effects on oxidative stress and inflammatory reaction. Methods. A total of 64 patients who underwent elective gynecological laparoscopic surgery in Yiwu Central Hospital from June 2019 to December 2020 were randomly divided into four groups (n = 16). Before anesthesia induction, oxycodone (group A), pentazocine (group B), ketorolac tromethamine (group C), and normal saline (group D) were, respectively, administered. Patients’ mean arterial pressure (MAP) and heart rate (HR) changes, visual analogue scale (VAS), Bruggemann comfort scale (BCS), serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), blood glucose (CLU), serum cortisol level, postoperative adverse reactions, and additional analgesia were recorded at each time point. Results. The MAP levels of T2 (immediate intubation), T3 (immediate catheter removal), and T4 (5 min after catheter removal) in the four groups were higher than those of T1 (quiescent state), and the HR levels T2, T3, and T4 were lower than those of T1 P < 0.05 . The MAP and HR levels of T2, T3, and T4 in patients of groups A, B, and C were lower than those of group D in the same period P < 0.05 . The VAS and BCS scores of groups A, B, and C at 1, 6, 12, and 24 h after operation were better than those of group D at the same time, and the scores of group A at 1 h and 6 h after operation were better than those of groups B and C at the same time P < 0.05 . The levels of serum TNF-α, IL-6, and CRP in the four groups of patients at 6, 12, and 24 h after operation were higher than those before operation, but those in groups A, B, and C were lower than those in group D, and those in group A were higher than those in groups B and C at 12 h and 24 h after operation P < 0.05 . The CLU and serum cortisol levels in the four groups were significantly higher at 6, 12, and 24 h after operation, but those in groups A, B, and C were lower than those in group D, and those in group A were lower than those in groups B and C at 6 and 12 h after operation P < 0.05 . There was no significant difference in the incidence of adverse reactions within 24 h between the four groups P > 0.05 . The incidence of additional analgesia in groups A, B, and C was lower than that in group D P < 0.05 . Conclusion. Oxycodone, pentazocine, and ketorolac tromethamine are effective and safe in inhibiting postoperative pain and the generation of inflammatory factors and relieving inflammatory state in gynecological laparoscopic pre-emptive analgesia. Oxycodone has better postoperative analgesic effect because it can effectively alleviate stress reaction.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Different Preemptive Analgesia on Postoperative Analgesia, Oxidative Stress, and Inflammatory Response after Gynecological Laparoscopic Surgery

Sun

Yang²,

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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show abstract

“…Commonly used pre-anesthetic medications include benzodiazepines [2][3][4], anticholinergic agents [1,[5][6][7], pentazocine [8,9], opioids [1], 5-HT3 antagonists [10], and metoclopramide and ranitidine [11]. Recently, we reported drug utilization pattern of pre-anesthetic medicines in patients undergoing major surgeries under general anesthesia [12]. The pattern of pre-anesthetic medications may differ based on the type of surgery, anesthetic agent and profile of the patient.…”

Section: Introductionmentioning

confidence: 99%

Pre-Anesthetic Medications in Patients Undergoing Exploratory Laparotomy: Results of a Cross-Sectional Study

Patil

Kulkarni

2018

Asian J Pharm Clin Res

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Objective: The objective of this study was to understand the pattern of pre-anesthetic medication utilization in patients undergoing exploratory laparotomy. Methods:In this cross-sectional study, we reviewed the records of patients who underwent exploratory laparotomy under general anesthesia. Descriptive data of the pre-anesthetic medications used in the patients are presented. Results:A total of 49 patients with mean ± SD age of 65.85±34.15 years were included in the study. The study population was dominated by male patients (65.85%). Two major indications for exploratory laparotomy in the study population were perforation peritonitis 19 (38.77%) and intestinal obstruction 9 (18.37%). Ondansetron was used in all patients. Metoclopramide and ranitidine were used in 48 (98%) patients each. Midazolam was given to 43 (87.8%) patients. A total of 41 (83.7%) patients received anticholinergic agent glycopyrrolate or atropine. Pentazocine and fentanyl were used in 39 (79.6%) and 10 (20.4%) patients, respectively. Conclusion:Ondansetron, metoclopramide, ranitidine, midazolam, glycopyrrolate, and pentazocine were the major pre-anesthetic medications in patients undergoing exploratory laparotomy. Glycopyrrolate was the most preferred anticholinergic agent.

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“…This has a peculiar feature associated with earlier discharge from the post-anesthesia care unit. 17 , 18 General anesthesia and surgery were responsible to develop postoperative complication like Postoperative Nausea and Vomiting (PONV) 19 , 20 although there are multi-factorial reasons for PONV. 21 – 24 So to compensate for the above postoperative complication appropriate drugs in Preanesthetic medicine and prophylaxis drugs were utilized before and after surgery to reduce the adverse effect.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Pre-Anesthetic Medications for Major Surgical Procedures at a Tertiary Care Center: A Descriptive Cross-sectional Study

Shah

Pradhan

Shah³

2020

J Nepal Med Assoc

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Introduction: Drug utilization research is an important tool to analyze the use of drugs with specialemphasis on medical, social, and economic consequences in society. This study aims to find out theutilization of pre-anesthetic medications in a major surgical procedure. Methods: A descriptive cross-sectional study was conducted from 15th April - 15th August 2019 inthe postoperative ward at Birat Medical College and Teaching Hospital. The convenience samplingmethod was used after ethical clearance from the Institutional Review Committee (IRC) of BiratMedical College and Teaching Hospital, Biratnagar, Nepal. About 400 patients were studied.The collected data were entered into a statistical package for social science version 20 for furthercalculations at 95% Confidence Interval. Results: Out of 400 patients, 215 (53.8%) of patients were underwent into different major surgeries.All patients received midazolam 2 mg except children (1 mg) and Pethidine 25 mg along with 0.2 mgglycopyrrolate 352 (88%), ondansetron 276 (69%) and others 58 (14.5%) as a preanesthetic agent. Forgeneral anesthesia propofol, 30 mg have been utilized followed by fentanyl 306 (76.5%) and others(halothane, isoflurane, etc) 115 (28.8%). In case of prophylactic drug were ceftriaxone 500 mg, 100 mgmetoclopramide 387 (96.8%), dexamethasone 251 (62.8%), tramadol 237 (59.3%), 15 mg ketorolac 368(92%), ranitidine 163 (40.8%), and pantoprazole 237 (59.3%). Conclusions: The most commonly administered pre-anesthetic drugs were midazolam, pethidine,glycopyrrolate, and ondansetron. The incidence of postoperative nausea and vomiting the patientwithin 24 hours after surgery was significantly very low.

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A Cross-Sectional Pharmacoepidemiological Study of the Utilization Pattern of Pre-Anesthetic Medications in Major Surgical Procedures in a Tertiary Care Hospital

Cited by 9 publications

References 13 publications

Efficacy of Different Preemptive Analgesia on Postoperative Analgesia, Oxidative Stress, and Inflammatory Response after Gynecological Laparoscopic Surgery

Efficacy of Different Preemptive Analgesia on Postoperative Analgesia, Oxidative Stress, and Inflammatory Response after Gynecological Laparoscopic Surgery

Pre-Anesthetic Medications in Patients Undergoing Exploratory Laparotomy: Results of a Cross-Sectional Study

Utilization of Pre-Anesthetic Medications for Major Surgical Procedures at a Tertiary Care Center: A Descriptive Cross-sectional Study

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