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Biomedical subjects

B K Huss

Publications and source records attributed to B K Huss.

6 recordsLinked to original sources
PubMed1998

Pain after vasectomy.

We studied the influence of the timing of injection of bupivacaine into the vas deferens on the intensity and duration of scrotal pain following vasectomy. Forty-two patients undergoing vasectomy under general anaesthesia were randomly allocated to have the operation performed on either the left or the right side first. On the first side to be operated upon, 5 ml bupivacaine 0.5% was infiltrated along the line of the scrotal incision. The vas deferens was identified and 1 ml bupivacaine 0.5% was injected into its lumen, with 0.5 ml directed proximally and 0.5 ml directed distally. After completion of the procedure on that side, the operation continued on the other side. On this occasion, the same dose of bupivacaine was injected into the vas deferens after division and ligation, and subcutaneously along the scrotal incision after skin closure. Median [interquartile range] visual analogue pain scores on the first side to be operated upon were significantly lower than on the second side on day 1 (7 [1.5-19] vs. 11 [2.5-47]) (p < 0.01) and day 7 (0 [0-8.5] vs. 0 [0-18.8]) (p < 0.05) postoperatively. The median [interquartile range] duration of postoperative discomfort was less on the first side operated upon than on the second (3 [1-7] vs. 6 [2-7]) (p < 0.01). Although statistically significant differences occurred between the treatment groups, the actual differences were small and may not be clinically significant.

Adult↗
PubMed1996

A comparison of the effect of intramuscular diclofenac, ketorolac or piroxicam on post-operative pain following laparoscopy.

Sixty patients presenting for in-patient gynaecological laparoscopic surgery were randomly allocated to receive either diclofenac 75 mg (n = 20), ketorolac 30 mg (n = 20) or piroxicam 20 mg (n = 20) as an intramuscular (i.m.) injection immediately after induction of anaesthesia. Post-operative Visual Analogue Scores at rest, over the first 24 h after surgery, using a 10 cm scale, ranged from 3.2-0.5 in the diclofenac group, 2.7-0.85 in the ketorolac group and 2.8-0.5 in the piroxicam group. The scores did not differ significantly between the three groups (P > 0.05). Mean time (SD) to first analgesia was 27 (94) min in the piroxicam group, 16 (30) min in the diclofenac group and 62 (120) min in the piroxicam group. Six out of 20 patients in the diclofenac group required further analgesia compared with nine out of 20 in the other two drug groups, this was not significant. There were no reports of increased bleeding, bronchoconstriction, bleeding from the upper gastrointestinal tract, renal impairment or pain from the intramuscular (i.m.) injection site in any of the groups. The administration of a non-steroidal anti-inflammatory drug to patients presenting for laparoscopic surgery reduces post-operative pain and analgesic requirements, and piroxicam 20 mg provides a suitable alternative to 75 mg diclofenac and 20 mg ketorolac.

Adult↗
PubMed1996

A comparison of the effect of intramuscular diclofenac, ketorolac or piroxicam on postoperative pain following laparoscopy.

Sixty patients presenting for in-patient gynaecological laparoscopic surgery were randomly allocated to receive either diclofenac 75 mg (n = 20), ketorolac 30 mg (n = 20) or piroxicam 20 mg (n = 20) as an intra-muscular injection immediately after induction of anaesthesia. Postoperative visual analogue scores over the first 24 hours, using a 10 cm scale, ranged from 3.2-0.5 in the diclofenac group, 2.7-0.85 in the ketorolac group and 2.8-0.5 in the piroxicam group. The scores did not differ significantly between the three groups (p > 0.05). Mean time (SD) to first analgesia was 27(94) minutes in the piroxicam group, 16 (30) minutes in the diclofenac group and 62 (120) minutes in the piroxicam group. Six out of twenty patients in the diclofenac group required further analgesia compared to nine out of twenty in the other two drug groups. This difference was not significant. There were no reports of increased bleeding, bronchoconstriction, bleeding from the upper gastrointestinal tract, renal impairment or pain from the intra-muscular injection site in any of the groups. The administration of a non-steroidal anti-inflammatory drug to patients presenting for laparoscopic surgery reduces postoperative pain. There were no obvious differences between the agents used.

Adult↗
PubMed1995

Intra-vas deferens bupivacaine for prevention of acute pain and chronic discomfort after vasectomy.

We have studied the use of intra-vas deferens local anaesthesia in 70 patients undergoing vasectomy as day-case patients. Patients were allocated randomly to either a control or treatment group. In the treatment group, 0.5% bupivacaine 1 ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas deferens in a randomized blinded design. The control group did not receive an injection. Patients were discharged with a questionnaire for recording visual analogue scores (VAS) for both the right and left sides to be scored on days 1 and 7 after operation. One year after the procedure a second questionnaire was sent out asking about the presence or absence of chronic testicular discomfort, its duration and any surgical intervention required to relieve it. There were no differences between the control group and the saline side of the treatment group in VAS scores on both day 1 and day 7 after operation or in the incidence and duration of chronic testicular discomfort (mean 30 (SD 53) and 34 (50) days, respectively). The VAS scores were, however, significantly less (P < 0.005) and testicular discomfort was absent on the bupivacaine-treated side.

Adult↗