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Background The effectiveness of postoperative pain relief regimens is well established and postulated to rely on diverse factors. Objective The aim of this study was to compare the effect of gabapentin and melatonin and dextromethorphan on postoperative pain control in patients undergoing hip fracture surgery under general anesthesia. Patients and methods In a double-blind controlled trial 125 patients requiring hip fracture surgery enrollment into the study after following ethical approval and informed participant consent. The patients were randomized to either each of the three regimens (gabapentin, melatonin, and dextromethorphan) by the block-randomization method. Outcome measurements were of foremost importance, patient’s pain scores throughout the recovery time and scheduled postoperative time intervals (2, 4, 6, 12, 24 h), doses of opioid use (mg) in the initial 24 h, and at length, sedation levels using the Ramsay scoring system at the early postoperative time intervals. Moreover, complications including chills, nausea, vomiting, and decreased consciousness were recorded. Statistical data analysis conducted by analysis of variance, χ 2, and repeated measurements through SPSS, version 20. Results Gabapentin-treated patients manifested the lowest blood pressures (P<0.05), with maximum pain relief being experienced, sedation level being greater (P<0.05), and opioid use being lower in the group (P=0.0001). Conclusion We have the impression that gabapentin could be connected with improving pain relief and sedation, whereas opioid use was observed comparatively lower in the initial 24 h, and hence inferentially. The premedication can be driven to be superior in creating favorable conditions for analgesia and sedation and effective in preventing complications requiring treatment within 24 h postoperatively versus baseline and promisingly suggested to be continued for postoperative pain management, procedural sedation quality improvement, and opioid use reduction within the initial 24 h.
Background The effectiveness of postoperative pain relief regimens is well established and postulated to rely on diverse factors. Objective The aim of this study was to compare the effect of gabapentin and melatonin and dextromethorphan on postoperative pain control in patients undergoing hip fracture surgery under general anesthesia. Patients and methods In a double-blind controlled trial 125 patients requiring hip fracture surgery enrollment into the study after following ethical approval and informed participant consent. The patients were randomized to either each of the three regimens (gabapentin, melatonin, and dextromethorphan) by the block-randomization method. Outcome measurements were of foremost importance, patient’s pain scores throughout the recovery time and scheduled postoperative time intervals (2, 4, 6, 12, 24 h), doses of opioid use (mg) in the initial 24 h, and at length, sedation levels using the Ramsay scoring system at the early postoperative time intervals. Moreover, complications including chills, nausea, vomiting, and decreased consciousness were recorded. Statistical data analysis conducted by analysis of variance, χ 2, and repeated measurements through SPSS, version 20. Results Gabapentin-treated patients manifested the lowest blood pressures (P<0.05), with maximum pain relief being experienced, sedation level being greater (P<0.05), and opioid use being lower in the group (P=0.0001). Conclusion We have the impression that gabapentin could be connected with improving pain relief and sedation, whereas opioid use was observed comparatively lower in the initial 24 h, and hence inferentially. The premedication can be driven to be superior in creating favorable conditions for analgesia and sedation and effective in preventing complications requiring treatment within 24 h postoperatively versus baseline and promisingly suggested to be continued for postoperative pain management, procedural sedation quality improvement, and opioid use reduction within the initial 24 h.
Background: Postoperative pain management has been linked with multiple clinically relevant complications such as thromboembolism, myocardial ischaemia, and cardiac arrhythmias. Objectives: The present study moves towards an evidence-based approach to the therapeutic efficacy of zolpidem and melatonin in a better clinically meaningful pain relief following intervertebral disc herniation surgery under general anaesthesia. Materials and Methods: Undertaking a randomised, parallel-group, double-blind, clinical trial, 60 patients meeting eligibility (mean age ≈ 39, 50% female and 50% men) were offered intervertebral disc surgery at the Arak-based Valiasr Hospital and stratified into two interventional arms by block randomisation. Data including (i) pain (visual analog scale) and sedation (Ramsay sedation scale) scores during recovery and at all five initial 24-h time points (two, four, six, 12, 24); (ii) adverse events inclusive of mild nausea and dizziness, pethidine consumption; and (iii) ongoing haemodynamic parameters, including heart rate, blood pressure, and oxygen saturation were collected. Data were analysed at a significance level of P = 0.05 (SPSS 20.0, IBM Corp). Results: Our results showed no perceived statistically significant between-arm difference in three functional haemodynamic parameters, duration of surgery, and adverse events, as well as in sedation and pain scores ( P < 0.05). Our results showed no between-arm difference in analgesia and sedation, haemodynamic changes, and postoperative adverse events. Conclusion: The findings taken together lent a strong support for the highly encouraging efficacy of both drugs in affording adequate analgesia at 24 postoperative hours without any adverse events needing to be thought of. Therefore, both zolpidem and melatonin were promising postoperative pain relievers, while no drug is demonstrably superior to the other.
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