scholarly journals Bayesian inference for causal mechanisms with application to a randomized study for postoperative pain control

Biostatistics ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 605-617 ◽  
Author(s):  
Michela Baccini ◽  
Alessandra Mattei ◽  
Fabrizia Mealli
Keyword(s):  
Postoperative Pain ◽  
Mediation Analysis ◽  
Pain Control ◽  
Randomized Study ◽  
Double Blind Study ◽  
Principal Stratification ◽  
Self Administration ◽  
Postoperative Pain Control ◽  
Double Blind ◽  
Effect Of Treatment

SUMMARY We conduct principal stratification and mediation analysis to investigate to what extent the positive overall effect of treatment on postoperative pain control is mediated by postoperative self administration of intra-venous analgesia by patients in a prospective, randomized, double-blind study. Using the Bayesian approach for inference, we estimate both associative and dissociative principal strata effects arising in principal stratification, as well as natural effects from mediation analysis. We highlight that principal stratification and mediation analysis focus on different causal estimands, answer different causal questions, and involve different sets of structural assumptions.

scholarly journals Pre-emptive analgesia VS Prophylactic analgesia and its influence on postoperative pain in postoperative laparoscopic cholecystectomy patients

2020 ◽  
Vol 1 (2) ◽  
pp. 038-043
Author(s):  
María Fernanda Maya Guerrero ◽  
Fabiola María Nuccio Giordano ◽  
Bernardo José Gutiérrez Sougarret ◽  
Alejandro Díaz Girón Gidi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Total Dose ◽  
Pain Control ◽  
Randomized Study ◽  
Pain Scale ◽  
Postoperative Pain Control ◽  
Double Blind ◽  
The Moment

Introduction: There are no studies on the use of dexketoprofen for postoperative pain control in patients undergoing laparoscopic cholecystectomy. Purpose: To assess if the timing of dexketoprofen administration influences the intensity of postoperative pain in patients undergoing laparoscopic cholecystectomy. Materials and methods used: Experimental, longitudinal, double-blind, randomized study. 50 mg of dexketoprofen diluted in 50 ml of 0.9% saline was administered to 50 patients divided into two groups: Pre-operative group: the substance was administered one hour before the beginning of surgery. Trans-operative group: the substance was administered at the moment when the gallbladder was separated from the liver base. The Numerical Pain Scale was evaluated and the number of doses and the total dose of tramadol that the patients received as analgesic rescue was quantified. Results: Administration of dexketoprofen before starting laparoscopic cholecystectomy tends to reduce the intensity of postoperative pain without being statistically significant. Conclusion: The timing of dexketoprofen administration has no impact on postoperative pain in patients operated for laparoscopic cholecystectomy.

scholarly journals A comparative evaluation of the effects on postoperative pain of systemic and topical forms of benzydamine hydrochloride after periodontal flap surgery: A randomized controlled clinical trial

2020 ◽  
Vol 7 (2) ◽  
pp. 394-399
Author(s):  
Gülhan Kocaman
Keyword(s):  
Postoperative Pain ◽  
Topical Application ◽  
Pain Control ◽  
Double Blind Study ◽  
Clinical Parameters ◽  
Flap Surgery ◽  
Postoperative Pain Control ◽  
Significant Difference ◽  
Spray Form ◽  
Periodontal Flap Surgery

Objective:  The aim of this study was to evaluate comparatively the topical and systemic forms in the postoperative pain control periodontal flap surgery in spite of the daily dose of benzydamine hydrochloride spray form about one in twenty of the oral dose,. Materials and Methods: In this randomized trial, the 48 systemic healthy individuals in need double-blind study with periodontal flap surgery were evaluated. Consent, demographic information and periodontal clinical parameters were obtained before surgery and periodontal flap surgery was performed with local anesthesia. The patients who underwent surgery were randomly assigned to two groups. One of the groups was prescribed tablet form of postopertive benzydamine hydrochloride and for the other was spray form as topical application. Postoperative pain was assessed by visual analog scale at 2, 6, 8, 12, 24 and 48 hours. Results: There was no difference between systemic and topical drug groups in terms of demographic characteristics and periodontal clinical parameters. A statistically significant difference was found between 2 and 6 hours in favor of topical application. (p <0.05), but there was no significant difference in pain intensity at the 8th, 12th, 24th and 48th hours. Conclusion: Although the topical form of benzydamine hydrochloride was 1/20 lower in postoperative pain control after periodontal flap surgery, it was found to be more effective in the early period compared to the systemic form, but equally effective in the late period. We premierly recommend that topical application should be preferred primarily in the prevention of overdose and toxicity in postoperative pain control after periodontal flap operation.

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