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Results for “Randomised controlled trials as topic”

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At least 235 records · Page 13Linked to original sources
PubMed2001

Efficacy of subcutaneous and topical local anaesthesia for pain relief after resection of malignant breast tumours.

OBJECTIVE: Infiltration and topical application of local anaesthetics close to the surgical wound may be used to prevent postoperative pain. We evaluated the efficacy of these treatments after breast surgery for cancer. DESIGN: Double-blind randomised trial with two treatment groups and one control group. SETTING: University hospital, Sweden. INTERVENTIONS: Patients were allocated to treatment with bupivacaine infiltration (n = 29), topical application of lignocaine/prilocaine (n = 31), or no local treatment (n = 30). MAIN OUTCOME MEASURES: Difference and time related patterns in pain scores measured on a visual analogue scale (VAS), and morphine consumption. RESULTS. None of the local anaesthetics significantly reduced the VAS score or morphine consumption. However, fewer patients in the anaesthetic groups had high VAS scores than controls, the 75 centile for the mean score after operation being 2.7, 2.0 and 2.1 for the controls, infiltration, and topical anaesthetic groups, respectively. The controls had higher scores from 6 hours postoperatively onwards. The corresponding median morphine consumption was 24.5, 18.5, and 16.2 mg. CONCLUSIONS. Local anaesthesia slightly reduced the overall pain scores and the morphine consumption, but was of potential clinical value only in the patients who had the highest pain scores.

Administration, Topical↗
PubMed2001

Patient reliability in the administration of topical ocular medication.

PURPOSE: To evaluate patient's reliability in the administration of eyedrops. METHOD: The study is based on a randomised, controlled clinical trial in which a steroid-containing drug delivery system (DDS) was directly compared to conventional steroid eyedrops after cataract surgery. 32 eyes undergoing extracapsular cataract extraction with intra-ocular lens insertion received a DDS, while 31 eyes received 0.1% dexamethasone eyedrops q.d.s for 30 days. Patients with DDS were given a placebo eyedrop in the form of 0.9% sodium chloride, while all 63 eyes received topical chloramphenicol eyedrops q.d.s for 30 days. At the conclusion of the 30 day visit, the eyedrop containers were collected and the residual volume of medication remaining in each bottle was then measured to the nearest 10 microlitre using a pipette. RESULTS: 31 patients returned the complete set of eyedrop containers. There was no statistical significant difference in the volume used between the types of eyedrops, sex and diabetic status. All the patients used more than the prescribed amount. Older patients tended to use less medication. CONCLUSION: The amount of medication that patients actually administered in this trial varied widely according to the individual, and patient age may be a factor affecting compliance in using eyedrops.

Age Factors↗
PubMed2006

Antibiotics versus placebo for acute bacterial conjunctivitis.

BACKGROUND: There are concerns about whether antibiotic therapy confers significant clinical benefit in the treatment of acute bacterial conjunctivitis. OBJECTIVES: The aim of this review was to assess the benefit and harm of antibiotic therapy in the management of acute bacterial conjunctivitis. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register), MEDLINE, EMBASE, SIGLE, NRR, PubMed and the reference lists of identified trial reports. We used the Science Citation Index to look for articles that cited the relevant studies, and we contacted investigators and pharmaceutical companies for information about additional trials. SELECTION CRITERIA: We included double masked randomised controlled trials in which any form of antibiotic treatment had been compared with placebo in the management of acute bacterial conjunctivitis. This included topical, systemic and combination (for example, antibiotics and steroids) antibiotic treatments. DATA COLLECTION AND ANALYSIS: One author extracted data and the accuracy was checked by a second author. MAIN RESULTS: This review includes five trials which randomised a total of 1034 participants. One further trial is currently 'awaiting assessment'. This has been published in abstract form and has yet to be fully reported. Three of the trials have been conducted on a selected specialist care patient population and the two more recent trials have been conducted in a community care setting. The trials were heterogeneous in terms of their inclusion and exclusion criteria, the nature of the intervention, and the outcome measures assessed. Meta-analyses of data on clinical and microbiological remission rates reveal that topical antibiotics are of benefit in improving early (days 2 to 5) clinical (RR 1.24, 95% CI 1.05 to 1.45) and microbiological (RR 1.77, 95% CI 1.23 to 2.54) remission rates; later (days 6 to 10) data reveal that these early advantages in clinical (RR 1.11, 95% CI 1.02 to 1.21) and microbiological cure rates are reduced (RR 1.56, 95% CI 1.17 to 2.09), but persist. Most cases however resolve spontaneously with clinical remission being achieved in 65% (95% CI 59 to 70) by days 2 to 5 in those receiving placebo. No serious outcomes were reported in either the active or placebo arms of these trials, indicating that important sight-threatening complications are an infrequent occurrence. AUTHORS' CONCLUSIONS: Acute bacterial conjunctivitis is frequently a self-limiting condition, but the use of antibiotics is associated with significantly improved rates of clinical and microbiological remission.

Acute Disease↗
PubMed2005

[Possible ways of managing cardiovascular prevention: polypharmacy, additional payment or application of evidence based medicine?].

The financial balance of the health care system has changed dramatically due to a longer life expectancy and improved treatment options in elderly patients. More than 80% of cardiovascular events are lifestyle related and potentially preventable. Lifestyle modification is therefore the causal approach to decrease cardiovascular events. Improvement of nutrition and activity habits and prevention of cigarette smoking should start in the kindergarten, school and later at the workplace. A co-operation between medical societies and government institutions is necessary to achieve a population wide modification of lifestyle habits to lower the incidence of cardiovascular events in the population. Individual risk stratification is the basis for pharmacological prevention of cardiovascular events. The concept of the polypill has to be tested in controlled randomised studies.

Cardiotonic Agents↗
PubMed1999

A review of the impact of pre-operative education on recovery from surgery.

Seminal research by Boore (Boore, J., 1978. Prescription for Recovery. RCN, London) and Hayward (Hayward, J., 1975. Information--a Prescription against Pain, RCN, London) demonstrated that pre-operative information reduces post-operative stress, pain and anxiety in general surgical patients. Both studies used experimental designs and the results are frequently cited in the UK nursing literature. However, they are now more than twenty years old and surgical practices, patterns of hospitalisation and nursing as well as patients' knowledge and expectations have changed enormously. Other more recent studies have sought to evaluate the impact of pre-operative education on post-operative recovery. This paper reviews the research published in this field since 1985. It focuses on studies in which an experimental design was used and considers the types of educational intervention employed and the impact on patient outcomes. A sequel paper will evaluate the research methods used in the light of current practice in the design and reporting of randomised controlled clinical trials.

Humans↗
PubMed1984

Topical pramoxine and hydrocortisone foam versus placebo in relief of post partum episiotomy symptoms and wound healing.

A double-blind randomised controlled trial, comparing pramoxine hydrochloride 1 per cent and hydrocortisone acetate 1 per cent in a mucoadhesive foam base, with simple aqueous foam (B.P.), in relieving episiotomy discomfort and episiotomy healing in 40 patients was carried out. Simple aqueous foam was more effective with regard to wound healing and episiotomy discomfort as measured by analgesic consumption. Pramoxine and hydrocortisone foam offers no advantage over simple aqueous foam in the treatment of post partum episiotomy discomfort.

Administration, Topical↗