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Background: Shivering is one of the most common post-operative complications, which, not only puts the patients to discomfort but may also lead to secondary complications such as suture releasing. Thus, several treatments like pethidine, ketamine and ondansetron were recommended for its prevention, but the three drugs are not compared in any previous studies. The aim of this study was to compare the preemptive effect of pethidine, ketamine and ondansetron on the prevention of post-operative shivering in patients undergoing abdominal surgery with general anesthesia. Methods: In a clinical trial study, during 2014-2015 in Alzahra hospital, Isfahan, Iran, 105 patients were selected and randomly divided in three groups of 35. The first, second and third groups received 0.5 mg/kg pethidine, 0.5 mg/kg ketamine and 8mg ondansetron, respectively, before abdominal surgery. Incidence of post-operative shivering was measured and compared between the three groups. Findings: None of the patients in pethidine group suffered from post-operative shivering but 3(8.6%) of ketamine and 3 (8.6%) of ondansetron had post-operative shivering (P = 0.240). Shivering intensity in 3(8.6%) of ketamine and 2(5.7%) of ondansetron were mild, also 1(2.9%) of ondansetron group had moderate shivering and frequency distribution of post-operative shivering was not statistically difference between the three groups (P = 0.370). Conclusion: All three groups of pethidine, ketamine and ondansetron have positive effect on prevention of post-operative shivering in abdominal surgeries and can be used based on patients’ physical status, diagnosis of anesthesiologist and surgeon, cost and drug availability.

Background: postoperative shivering is a common complication of various surgical, so far no acceptable theory has been presented on the prevention of it. The aim of this study was to compare the effect of intravenous injection of dexmedetomidine, ondansetron, and pethidine on postoperative shivering among patients under abdominal surgery. Materials and Methods: In a double-blind clinical trial study, 128 patients undergoing abdominal surgery were selected and randomly divided into four groups of 32. In the 4 groups, 0.5 μg/kg dexmedetomidine, 0.5 mg/kg pethidine, 0.1 mg/kg ondansetron, and the same volume of normal saline were injected intravenously when anesthetics were discontinued and the incidence and severity of postoperative shivering were determined and compared in four groups. Results: The incidence of postoperative shivering was 12.5% in the dexmedetomidine group, 31.3% in the ondansetron group, 31.3% in the pethidine group, and 50% in the control group (P = 0.015). The mean of shivering severity in the four groups was 1.33 ± 0.5, 0.17 ± 0.8, 1.09 ± 0.4, and 1.13 ± 0.39, and the difference between the four groups was significant (P = 0.005). Conclusion: The use of all three drugs of dexmedetomidine, ondansetron, and pethidine is effective in decreasing the incidence of postoperative shivering, but the use of dexmedetomidine is associated with less postoperative shivering, better hemodynamic stability, and fewer other postoperative complications.

Colonoscopy is a key procedure for the early detection of colorectal cancer. Despite its importance, the discomfort associated with colonoscopy often requires sedation, and the ideal sedation regimen remains to be determined. In this prospective randomized controlled trial, patients scheduled for colonoscopy were randomly assigned to two different sedation protocols. Group A received a combination of midazolam and propofol, while group B was given midazolam and pethidine. The study analyzed data from 51 patients, with 23 in group A and 28 in group B. The incidence of adverse events was similar across both groups. Additionally, no significant differences were observed in cecal intubation times or total procedure durations. Notably, group A had a lower frequency of required postural changes (1.0±0.7 vs. 1.5±0.7, p=0.02) and a reduced rate of manual compression (52.2% vs. 82.1%, p=0.02). There were no significant differences between the groups regarding subjective pain or overall satisfaction. Both sedation regimens were found to be safe and effective. The midazolam and propofol combination was associated with a smoother procedure, evidenced by fewer postural adjustments and less manual compression needed during colonoscopy. [ABSTRACT FROM AUTHOR]

Pethidine (PET) is an opioid pain-relief medicine with high addiction potential, especially among health professionals. Pethidine is commonly prescribed in Turkey as a pain-relieving medication for operative purposes. Due to its accessibility, low cost, user-friendliness, and effectiveness, PET is often misused by both healthcare professionals and patients. For this reason, analytical determination methods for PET abuse are essential in terms of forensic toxicology. In this study, a fast, reliable, and accurate gas chromatography-mass spectrometry method was developed for the first time in Turkey for the simultaneous detection of PET and its main urinary metabolite norpethidine (NPET). The method was validated in terms of selectivity, linearity, the limit of detection (LOD), the limit of quantification (LOQ), trueness, and precision according to the Scientific Working Group for Forensic Toxicology guidelines. The linear range was between 0.125-25.00 μg/mL for PET and 1.00-20.00 μg/mL for NPET. The LOD values for PET and NPET were 0.05 µg/mL and 0.49 µg/mL, while the LOQ values were 0.125 µg/mL and 1.00 µg/mL, respectively. Extraction efficiencies were calculated as 113% for PET and 104% for NPET. The intra-assay and inter-assay precision results were within acceptable limits. In the presented study, the validated method was applied to the urine of 18 patients collected at the 1st and 3rd hours after receiving PET. All samples in the study were collected under patients' consent and in line with ethical guidelines., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Recent studies have shown that anesthetic drugs can cause postoperative shivering. The incidence of postanesthetic shivering varies between 5 and 65% and patients report it as one of the leading causes of discomfort after operation. It may also induce a variety of physiological consequences such as increased O2 consumption and cardiac output. The effect of alfentanil, sufentanil and ketamine on prevention or decrease of postanesthetic shivering is not still clear. This study was performed to find out a suitable alternative for pethidine in prevention of postanesthetic shivering. Methods: In this randomized double-blind prospective study, 160 patients were classified into five equal groups according to drugs used for prevention of postoperative shivering after general anesthesia. Alfentanil, sufentanil, ketamine and pethidine groups received the drugs 30 minutes before the end of surgery and were compared with placebo (control group). The primary outcome measures were the incidence and severity of postoperative shivering. Findings: The five groups were were not different regarding age, gender, height, weight and the physical status class based on the American Society of Anesthesiologists score. In recovery room, postoperative shivering was seen in 18 patients, 2 in ketamine, 2 in pethidine, 4 in alfentanil, 3 in sufentanil and 7 in placebo group. Fisher’s exact test showed no statistically difference between the groups (P = 0.34). Conclusion: Intravenous infusion of alfentanil, sufentanil and ketamine 30 minutes before the end of surgery effectively reduced the occurrence and severity of postoperative shivering after the general anesthesia, without significant side effects but not as well as pethidine.

مقدمه: لرز بعد از عمل، یکی از شایع‌ترین عوارض بعد از عمل است که جهت پیش‌گیری و کنترل آن تا کنون روش‌های مختلفی به کار گرفته شده است. هدف از انجام مطالعه‌ی حاضر، مقایسه‌ی تأثیر افزودن پتیدین یا سوفنتانیل به مارکائین اینتراتکال بر پیش‌گیری از لرز بعد از عمل جراحی دیسک کمر در مقایسه با گروه شاهد بود. روش‌ها: طی یک مطالعه‌ی کارآزمایی بالینی، 126 بیمار کاندیدای عمل جراحی دیسک کمر در سه گروه 42 نفره توزیع شدند. به گروه اول، 5/0 سی‌سی نرمال سالین، به گروه دوم 5/0 سی‌سی سوفنتانیل و به گروه سوم 5/0 سی‌سی پتیدین به مارکائین اضافه شد و بروز لرز بعد از عمل در سه گروه مقایسه گردید. یافته‌ها: میانگین شدت لرز در ریکاوری در سه گروه نرمال سالین، سوفنتانیل و پتیدین به ترتیب 66/0 ± 40/2، 10/1 ± 88/1 و 34/0 ± 07/1 به دست آمد و اختلاف سه گروه معنی‌دار بود (001/0 > P). همچنین، بر حسب آزمون تعقیبی Fisher's least significant difference (Fisher's LSD) شدت لرز بین دو گروه نرمال سالین و سوفنتانیل (002/0 = P)، دو گروه نرمال سالین و پتیدین (001/0 > P) و دو گروه پتیدین و نرمال سالین (001/0 > P) اختلاف معنی‌داری داشت. نتیجه‌گیری: استفاده از سوفنتانیل در اعمال جراحی دیسک کمر تحت بی‌حسی نخاعی، باعث کاهش بیشتر در بروز لرز بعد از عمل نسبت به پتیدین نمی‌شود، اما در مقایسه با نرمال سالین، باعث کاهش بروز و شدت لرز بعد از عمل می‌گردد. از این رو، با توجه به عوارضی که از لرز بعد از عمل بیان گردید، در دسترس بودن سوفنتانیل و قیمت مناسب آن و همچنین، عدم تأثیر سوء این دارو بر همودینامیک بیماران، مصرف آن در اعمال جراحی دیسک کمر توصیه می‌گردد.

Background: Postoperative pain is a common phenomenon, and its management affects considerably on the recovery process, and patients’ satisfaction. Apotel and pethidine are two conventional medicines used to relieve pain after operation. Objectives: The present study aimed to compare the effect of intravenous injection of Apotel and intramuscular injection of pethidine in relieving pain after hemilaminectomy. Materials & Methods: In the present cross-sectional study, 150 patients who underwent hemilaminectomy were recruited between May 2015 and November 2015. They were taking either Apotel (n=75) or pethidine (n=75) after the operation, which was done at Poursina Hospital affiliated to Guilan University of Medical Sciences, Rasht City, Iran. The patients’ pain levels were measured using visual analog scale (VAS), and the results were compared between the 2 groups. Results: There was no significant difference in the total VAS score between the Apotel and pethidine groups (P=0.189). However, there was a significant reduction in VAS score hours 2 (P=0.03) and 4 (P=0.004) hours after the injection of Apotel in this group, compared with those scores in the pethidine group. Also, VAS scores at other times (8, 12, 20, 28 hours after the injection) were lower than those in the pethidine group, but the difference was not significant. Conclusion: Apotel was better pain-killer in the early hours after the first injection compared to pethidine. But its effect was similar to pethidine at the late hours after the first injection. Therefore it seems that Apotel is better painkiller after laminectomy, especially in the early hours after the operation.

Purpose: To compare the safety and efficacy of xylocaine gel and ketorolac as opioid-sparing analgesia compared with pethidine for shock wave lithotripsy (SWL) pain. Materials and Methods: A single-blinded randomized controlled trial (RCT) was performed in 132 patients with renal and upper ureteral stones amenable to treatment with SWL. The first patient group received intravenous (IV) pethidine and placebo gel; the second group received IV ketorolac plus placebo gel; the third group received lidocaine gel locally plus normal saline IV. Stone disintegration was classified as none (no change from basal by kidney, ureter, bladder X-ray or ultrasound [US] imaging), partial (fragmented and >4-mm residual fragments), and complete (≤4-mm residual fragments). Stone disintegration was assessed by kidney-ureter-bladder X-ray and US imaging. Pain was evaluated by use of the Numeric Pain Rating Scale (NPRS). Results: The NPRS scores were highest in the xylocaine group at 10, 20, and 30 minutes (p=0.0001) with no significant difference between the ketorolac and pethidine groups, except at 10 minutes (p=0.03) and a near significant difference at 30 minutes (p=0.054) in favor of ketorolac. Results for stone disintegration (none, partial, and complete, respectively) were as follows: 25 (50.0%), 23 (46.0%), and 2 (4.0%) for pethidine; 19 (35.8%), 23 (43.4%), and 11 (20.8%) for ketorolac; and 26 (89.7%), 3 (10.3%), and 0 (0.0%) for lidocaine (p=0.008). Conclusions: Ketorolac is a safe and more effective alternative to morphine derivatives for SWL analgesia. Lidocaine gel should not be used as mono-analgesia for SWL.

Background: Currently, there is a lack of an established standard or protocol for the management of post-spinal anesthesia shivering (PSAS). We compared the efficacy of intravenous use of three drugs, e.g., acetaminophen, dexamethasone, and pethidine in prevention of PSAS. Methodology: We included 108 patients who were randomly assigned to three equal groups of 36 patients each. Group A patients received pethidine infusion at 0.5 mg/kg; Group B patients were infused with acetaminophen 15 mg/kg and Group C was given dexamethasone infusion at 0.1 mg/kg. The degree of shivering at its onset was determined using the Bedside Shivering Assessment Scale (BSAS). Data was analyzed using Statistical Package for Social Science (SPSS) version 22. Results: PSAS was observed in 10 (27.7 %) patients in Group A vs. 14 (38.8 %) patients in Group B (P = 0.32), and 21 (58.3 %) patients of Group C (P = 0.01). The P-value between B vs C was 0.10, and between all the groups was 0.03. The BSAS score was 26 in Group A (75% patients out of 36 did not develop shivering), 22 in Group B, and 15 in Group C. The P-value between A vs. B was 0.01, A vs. C = 0.01, B vs. C = 0.12, and between all groups was 0.02. Conclusion: Aacetaminophen was more effective than dexamethasone, while pethidine was more effective than both, acetaminophen as well as dexamethasone, in decreasing the incidence of post-spinal anesthesia shivering. [ABSTRACT FROM AUTHOR]

A simple and rapid dispersive liquid–liquid microextraction (DLLME) technique coupled with gas chromatography–ion trap mass spectrometry (GC–MS) was developed for the extraction and analysis of methamphetamine (MA), pethidine (PD), ketamine (KT) and tramadol (TD) from human urine. In this study, different parameters affecting the extraction process such as the type and volume of extraction solvent, type and volume of disperser solvent, extraction time and pH value and salt effect were studied and optimized. Under optimized conditions, the enrichment factor ranged from 185 to 226 and the average recovery ranged from 80.45% to 95.55%. The linear range was 10.0–1000.0 µg/L, the limit of detection and quantitation were in the range 0.43–1.96 µg/L and 1.44–6.53 µg/L, respectively. The relative standard deviations were in the range 1.98%–3.90% (n = 7). The obtained results show that DLLME combined with GC–MS is a fast and simple method for the determination of MA, PD, KT and TD in human urine.

Aim and objective : There is growing increase in the rate of caesarean section delivery. Opioid analgesic use, one of the corner stone options is limited by the development of adverse effects. This study evaluated the efficacy of a multimodal method of pain management with or without opioid analgesic. Patients and Method : Sixty four pregnant women scheduled for elective caesarean section under spinal anesthesia, were randomized to two groups of 32 subjects each. Group PD received 1gm of intravenous paracetamol infusion and 75mg of intramuscular diclofenac while group P received 50mg of IV pethidine at the end of surgery. Both groups also had wound infiltration with 20mls of 0.1% plain bupivacaine (20mg) after skin closure. The proportion of patients who had VAS of d"3 at various time intervals, time to first analgesic request, patient′s satisfaction and side effects/ wound break down were compared. Results : There was no statistical difference between the proportions of patients that were pain free at various time intervals over a period of 24 hours post- operatively, the time to first analgesic request between the groups was not statistically significant. The duration was 242±2.1minutes for the PD group and 181.7±22.1minutes for P group. (P value=0.28). Higher incidences of side effects were observed in the P group with no statistical differences. Patients′ satisfaction was better in the PD group compared to the P group. Conclusion : The study demonstrates that a combination of paracetamol infusion and intramuscular diclofenac has similar analgesic efficacy as intravenous pethidine. This combination can be a good substitute for pethidine.

Background: Shivering is a common complication of general and epidural anesthesia. Warming methods and many drugs are used for control of shivering in the recovery room. The present study is a randomized clinical trial aimed to investigate the effects of two interventions in comparison with pethidine which is the routine treatment on shivering in patients undergoing abdominal surgery with general anesthesia. Materials and Methods: Eighty-seven patients undergoing abdominal surgery by general anesthesia were randomly assigned to three groups (two intervention groups in comparison with pethidine as routine). Patients in warmed intravenous fluids group received pre-warmed Ringer serum (38°C), patients in combined warming group received pre-warmed Ringer serum (38°C) accompanied by humid-warm oxygen, and patients in pethidine group received intravenous pethidine routinely. The elapsed time of shivering and some hemodynamic parameters of the participants were assessed for 20 min postoperatively in the recovery room. Then the collected data were analyzed by software SPSS (v. 16) with the significance level being P < 0.05. Results: The mean of elapsed time in the warmed intravenous serum group, the combined warming group, and the pethidine group were 7 (1.5) min, 6 (1.5) min, and 2.8 (0.7) min, respectively, which was statistically significant (P < 0.05). The body temperatures in both combined warming and pethidine groups were increased significantly (P < 0.05). Conclusions: Combined warming can be effective in controlling postoperative shivering and body temperature increase.

Background: The study was aimed to evaluate the safety and efficacy of fentanyl and pethidine on the sedative quality of patients who underwent phacoemulsification cataract surgery with Propofol. Materials and Methods: In this double-blind randomized controlled clinical trial, patients who were candidates for elective phacoemulsification surgery with topical anesthesia were enrolled. The selected patients were randomly allocated into the two groups for receiving sedation with Propofol-Pethidine (PP) or propofol-fentanyl (PF) combinations. Demographic characteristics, hemodynamic parameters before, during, and after the operation, sedation and pain scores, and patients' and surgeons' satisfaction scores were compared in the two studied groups. Results: In this trial, 70 patients (35 patients in each group) have completed the study. Mean (standard deviation) operation time was 22.9 (6.8) and 25.46 (7.7) minutes in PF and PP groups (P = 0.118).Mean pain score in PF 0.46 (0.14) was significantly higher than PP groups 0.236 (0.06) (P = 0.011). The mean value of diastolic and systolic blood pressures, pulse rate, and mean arterial pressure dioxide were significantly decreased in both PF and PP groups (PTime< 0.001), although there was no significant difference between groups. Conclusion: Our findings indicated the equivalence effects on hemodynamic parameters for both pethidine and fentanyl in combination with propofol in which they could provide appropriate sedation and safe anesthesia with lower complications and acceptable patients' and surgeons' satisfaction.

Background: Postoperative shivering is an important complication following spinal anaesthesia. It is interferes with monitoring devices distressing to the patient and increases oxygen consumption. The aim of this study was to compare the effectiveness of pethidine and dexamethasone in the prevention of postoperative shivering after spinal anesthesia for caesarean section. Methods: In this prospective, randomized, double-blind study, 99 obstetric patients with ASA I–II (American Society of Anesthesiologists) undergoing elective caesarean section under spinal anaesthesia were randomly allocated to one of three equal groups: Group D received 0.15 mg/kg dexamethasone, Group P received 0.5 mg/kg pethidine and Group C (control) received normal saline. The drugs were given intravenously immediately after delivery of the infant with recording of axillary and core temperature and vital signs in several time intraoperative and every 10 minutes in recovery room. The incidence and intensity of shivering, number of patients received pethidine, sensory level, pain (in visual analogue scale), and side effects (hypotension, hypertension, tachycardia, bradycardia, sedation, nausea and vomiting) were also recorded. Findings: Incidence and intensity of shivering were reduced in groups P and D compared to group C (P < 0.05). The means of shivering score were 0.03, 0.15 and 0.27 in groups P, D and C, respectively. Receiving pethidine to control shivering after the surgery was significantly lower in groups P and D compared to group C (P < 0.05). There were no significant differences in vital signs, axillary and core temperature, sensory level and side effects among all groups. Conclusion: The prophylactic use of 0.15 mg/kg dexamethasone is effective for shivering prophylaxis in women undergoing cesarean section under spinal anaesthesia.

مقدمه‌: پیش‌گیری و کنترل لرز پس از عمل جراحی از اهمیت قابل توجهی برخوردار است؛ روش‌های مختلی بدین منظور مورد استفاده قرار می‌گیرد. در این تحقیق، به بررسی مقایسه‌ای سه داروی دگزامتازون، پتیدین و هیوسین در پیش‌گیری از بروز لرز پس از عمل جراحی پرداخته شد. روش‌ها: در این تحقیق کارآزمایی بالینی، 90 بیمار کاندید عمل جراحی کله‌سیستکتومی ار طریق لاپاروسکوپی، به طور تصادفی به 3 گروه مساوی تقسیم‌بندی شدند. در گروه اول mg/kg 5/0 پتیدین، در گروه دومmg/kg 1/0دگزامتازون و در گروه سوم mg/kg 15/0 هیوسین مورد استفاده قرار گرفت و شیوع لرز پس از عمل جراحی و شدت آن در سه گروه بررسی و مقایسه شد. داده‌های مطالعه با استفاده از نرم‌افزار SPSS تجزیه و تحلیل آماری شد. یافته‌ها: در سه گروه پتیدین، هیوسین و دگزامتازون به ترتیب 0/60، 3/43 و 4/54 درصد افراد فاقد لرز بودند. همچنین، در این سه گروه به ترتیب، 0/20، 3/13 و 3/23 درصد بیماران لرز خفیف، 7/16، 3/33 و 7/6 درصد افراد لرز متوسط و 3/3، 0/10 و 0/10 افراد لرز شدید داشتند. شدت لرز در سه گروه اختلاف معنی‌داری نداشت (16/0 = P). استفاده از پتیدین باعث کاهش معنی‌دار در شدت درد بعد عمل شد و دو داروی هیوسین و دگزامتازون بر کاهش شدت تهوع و مصرف متوکلوپرامید، تأثیر مطلوب‌تری نسبت به پتیدین داشتند. نتیجه‌گیری: سه داروی پتیدین، هیوسین و دگزامتازون تفاوت قابل توجهی در کاهش بروز لرز بعد عمل ندارند ولی در کنترل سایر عوارض، متفاوتند. پیشنهاد می‌گردد، در مطالعات بعدی، تأثیر ترکیبی داروهای مذکور بر عوارض بعد عمل در بیماران تحت اعمال جراحی مورد مطالعه قرار گیرد.

The article presents a case of a patient treated with pethidine for several years due to stump pain. Due to numerous somatic (symptoms associated with concomitant cancer), mental (depressive and anxiety disorders), and social (disability) burdens, insufficient support from the environment, and improperly conducted pain therapy, the patient independently sought ways to cope with a difficult situation, which led to pethidine addiction. The use of the drug brought the patient temporary relief in the physical dimension. However, it led to the consolidation of incorrect behaviour and deterioration of quality of life. The paper presents the rotation of opioids used in the discussed case, which resulted in satisfactory analgesia. The description of the case was supplemented with a psychologist's comment. [ABSTRACT FROM AUTHOR]

Background: The use of transcutaneous electrical nerve stimulation (TENS) to relieve labor pain remains controversial and existing evidence is neither strong nor consistent. This research was designed to compare TENS' effect with the injection of pethidine and promethazine in labor pain reduction., Methods: In this trial, for 45 pregnant women in the active phase of labor, TENS electrodes were placed (two on both arms, and two over the participants' low back) continuously for 120 minutes; and for another group 45 pregnant women, 100 milligrams of pethidine and 250 micrograms of promethazine were injected intramuscularly which could be repeated once at least one hour later. Labor pain and duration, need for labor induction/augmentation/other pain control methods/ instrumental delivery, delivery type, and maternal and newborn complications were measured in both groups., Results: The baseline mean visual analog scale (VAS) score, in the TENS group was 8.51±0.62 and in the pethidine and promethazine groups was 8.37±0.61 (P=0.31). While in a 120min post-intervention, it was 6.29±1.50 and 5.73±1.46 in the TENS group and the pethidine and promethazine group, respectively with no statistically significant difference (P=0.07). The labor duration in the TENS group was 6.61±1.71 hours and in the pethidine and promethazine group was 6.17±2.07 hours, with no statistically significant difference (P=0.33). In addition, no complication was recorded neither in the mothers nor newborns., Conclusion: This study showed that applying TENS in the active labor phase can reduce at least two scores in patient labor pain with no significant complications., Competing Interests: The authors indicate no conflict of interests.

Pethidine is an opioid derivative typically used to treat moderate-to-severe pain. It has a good analgesic effect and is considered safe, although with adverse effects such as nausea, depression, vomiting, respiratory depression, and toxicity. We discuss the case of a 43-year-old female patient who received intravenous pethidine and developed skin necrosis in multiple areas of the body as a complication and how it was managed. This is the first report in the literature discussing skin necrosis after intravenous pethidine., Competing Interests: The author declares that he has no competing interests., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.)

Objectives: Recently, intravenous acetaminophen has been introduced as an intervention with analgesic potential similar to that of opioid analgesics in labor pain management. This study aimed to compare the pain score and maternal and neonatal complications following acetaminophen and pethidine injections during vaginal delivery. Methods: This randomized, double-blind clinical trial was conducted on pregnant women during the first stage of delivery referred to Ghaem and Omolbanin Hospitals in Mashhad, Iran, from March to December 2017. The subjects were assigned randomly to one of two groups: acetaminophen and pethidine. The pain intensity was measured before and 15, 60, 120, 180, and 240 minutes after injection. Results: The pain score and pain score changes showed no significant difference between the two groups at different times. The incidence of maternal complications during delivery and the first hour after delivery was not statistically significant between the two groups, but 15 minutes after injection, vomiting (p = 0.001), nausea (p = 0.001), and dizziness (p = 0.001) were significantly higher in the pethidine group. The mean one and five minutes Apgar scores were significantly higher in the acetaminophen group. Conclusions: Intravenous acetaminophen led to fewer maternal complications than pethidine, especially during the first 15 minutes after injection and fewer neonatal complications, especially in the Apgar score.

Objective: To compare the effectiveness of Ketamine vs Pethidine for treating postoperative shivering in patients undergoing surgery under general anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Operation Theatre, Combined Military Hospital Sialkot Pakistan, from Jan to Apr 2020. Methodology: Following strict inclusion and exclusion criteria, patients who experienced postoperative shivering in the postanesthesia care unit (recovery) were enrolled through consecutive sampling and randomized into group-A or group B using the lottery method. Group-A received Pethidine 0.5 mg/kg and Group-B received Ketamine 0.2 mg/kg. The shivering grade was evaluated at 0 minutes and 5 minutes after administration of drugs by using a validated four-point scale. Results: Mean age of the patients was 34.12 ± 9.88 years and 34.83 ± 9.77 years in group-A and group B, respectively. At 5 min, the recovery rate of shivering was significantly higher in the Pethidine group than in the Ketamine group. In group-A, effecttiveness (grade 0) was noticed in 124 patients (86.2%) and in group-B effectiveness (grade-0) was seen in 74 patients (51.4%). A statistically significant difference (p<0.01) was found between the two groups. Conclusion: Pethidine 0.5 mg/kg is a more effective drug for treating postoperative shivering. [ABSTRACT FROM AUTHOR]

Abstract Background There is a lack of evidence comparing the use of propofol as a single agent with pethidine/midazolam combined for sedation in upper gastrointestinal (GI) endoscopy in developing countries. The aim of this study was to compare the benefits of sedation using propofol as a single agent to pethidine combined with midazolam in Ghana. Methods During the first 6 months of this study, all patients (137) undergoing diagnostic upper GI endoscopy at the Tamale Teaching Hospital (TTH) received pethidine/midazolam, and the following 6 months, all patients (104) received propofol. A total of 241 patients were enrolled in the study. The duration of the procedure and recovery time were recorded, and a structured questionnaire was then administered to determine patient satisfaction, level of sedation and amnesia. Results The mean time of recovery from sedation was significantly lower in propofol group than in pethidine and midazolam group (12.6 min vs. 33.7 min; p

Background: Pain and shivering are two challenging components in the post operative period. Many drugs were used for prevention and treatment of them. The aim of this study was to compare the effects of prophylactic prescription of diclofenac suppository versus intravenous (IV) pethidine in spinal anesthesia. Materials and Methods: We conducted a multi central, prospective, double-blind, randomized clinical trial on a total of 180 patients who were scheduled for surgery under spinal anesthesia including 60 patients in three groups. Patients were randomly allocated to receive 100 mg sodium diclofenac suppository or 30 mg IV pethidine or placebo. Categorical and continuous variables were analyzed by Chi-square test, t-test, Mann-Whitney and ANOVA or Kruskal-Wallis tests. Results: There was no statistical difference with regard to patient characteristics and hemodynamic indices among the three groups. Nine (15%), 10 (16.65%) and 24 (40%) of patients in diclofenac, pethidine and control groups reported pain and 2, 2, 7 patients received treatment due to it, respectively (P = 0.01). Prevalence of shivering in pethidine group and diclofenac group was the same and both of them were different from the control group (P < 0.001). Pruritus was repetitive in the pethidine group and was statistically significant (P = 0.036) but, post-operative nausea and vomiting was not significantly different among groups. Conclusion: A single dose of sodium diclofenac suppository can provide satisfactory analgesia immediately after surgery and decrease shivering without remarkable complications. This investigation highlights the role of pre-operative administration of a single dose of rectal diclofenac as a sole analgesic for early post-operative period.

Background: Cleft lip is one of the most common congenital anomalies in the world. There has been recently a considerable increase in use of local methods. In this regard, opioids are the common adjuvants but their safety and efficacy have not been studied extensively in children undergoing cleft lip repair. Therefore, we aimed to investigate the efficacy of local pethidine in comparison with intravenous pethidine in patients undergoing bilateral infraorbital nerve block. Methods: In this prospective, randomized, double-blind study, 40 children undergoing cleft lip repair allocated randomly to two groups. Group 1 received infraorbital injection of Marcaine and pethidine; and group 2 received infraorbital injection of Marcaine and intravenous pethidine. Statistical analysis was performed using SPSS software. Findings: The mean pain score was 5.15 ± 1.87 and 5.85 ± 2.10 in groups 1 and 2, respectively (P = 0.21). There was no significant difference in postoperative analgesic requirements between the groups (P > 0.05). There were no major complications in both groups. Conclusion: There was no significant differences between addition of pethidine to Marcaine and intravenous injection of pethidine in terms of postoperative pain score, duration of hospitalization, and postoperative analgesic requirements. Although no major complications were found, intravenous injection of pethidine is not suggested for cleft lip repair in children.

Background and Aim: Treatment of acute postoperative pain is one of the most important measures to improve recovery. Different methods of local and regional anesthesia, and also numerous intravenous drugs have been used. In this study, the analgesic effect ketorolac, paracetamol and pethidine in the postoperative pain control of outpatient transurethral lithotripsy was evaluated. Materials and Methods: This clinical trial was performed on 96 patients who were candidates for outpatient transurethral lithotripsy in Mashhad Imam Reza Hospital. In randomized double blinded study, at the end of the operation, 30 mg of intravenous ketorolac to the first group, 1 gram paracetamol in half an hour to the second group and 50 mg of pethidine to the third group were injected. Pain was assessed every 10 minutes to half an hour and then, every half an hour to 4 hours by numerical rating scale )NRS(. Finally, the data were analyzed by SPSS v16 software. The relationship between quantitative variables was analyzed by analysis of variance and the qualitative variables was assessed by Chi-square test and P<0.05 was considered significant. Results: There was no significant difference between three groups in demographic information. The pain intensity in the first 10 minutes after surgery was the same between the groups (P=0.372), but the pain intensity at 20, 30 and 60 minutes after surgery was significantly different in the three groups )P.values 0.005, 0.006, and 0.001 respectively(, and was lower in the pethidine group. In other hours after surgery, no significant difference in pain control was observed between the three groups. The need for additional analgesia was higher in the paracetamol group than in the other two groups (P=0.025) in the first hour. Hemodynamic changes and surgical complications such as nausea and vomiting were the same in both groups. Conclusion: The present study showed that pethidine causes better pain relief than ketorolac and paracetamol in the first hour after surgery, but after 60 minutes there is no significant difference between these three groups. [ABSTRACT FROM AUTHOR]