Displaying publications 2141 - 2160 of 10013 in total

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  1. Gunasagaran J, Sean ES, Shivdas S, Amir S, Ahmad TS
    J Orthop Surg (Hong Kong), 2017 Sep-Dec;25(3):2309499017739499.
    PMID: 29141522 DOI: 10.1177/2309499017739499
    PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups.

    METHODS: Between July and October 2016, a total of 72 patients were diagnosed with carpal tunnel syndrome, trigger finger or ganglion, at the University Malaya Medical Centre. Forty patients consented to participate in this study and were randomized into WALANT and LA/tourniquet groups. Anaesthesia was administered accordingly and tourniquet was applied. The time taken for preoperative preparation and surgery was recorded. Each surgeon estimated the blood loss. The perceived comfort level of each patient was quantified using a visual analogue score (VAS). Data were analysed using SPSS.

    RESULTS: The mean VAS for the WALANT group was 2.33 ± 1.94, whereas it was 4.72 ± 3.05 for the LA/tourniquet group, and the difference was statistically significant ( p < 0.05). The mean time for preoperative preparation in WALANT group was 19.17 ± 12.61 min and LA/tourniquet group was 7.05 ± 3.44 min. The difference between these groups was statistically significant ( p < 0.01). There was no significant difference in operating time and blood loss.

    CONCLUSION: WALANT technique was associated with better patient comfort. Tourniquet was the main reason for discomfort during surgeries. WALANT is an alternative in minor hand surgeries for a bloodless surgical field without the discomfort of tourniquet application.
  2. Hasan MK, Ahamed MA, Ahmad M, Rashid MA
    Appl Bionics Biomech, 2017;2017:6848014.
    PMID: 28894351 DOI: 10.1155/2017/6848014
    Electroencephalographic signal is a representative signal that contains information about brain activity, which is used for the detection of epilepsy since epileptic seizures are caused by a disturbance in the electrophysiological activity of the brain. The prediction of epileptic seizure usually requires a detailed and experienced analysis of EEG. In this paper, we have introduced a statistical analysis of EEG signal that is capable of recognizing epileptic seizure with a high degree of accuracy and helps to provide automatic detection of epileptic seizure for different ages of epilepsy. To accomplish the target research, we extract various epileptic features namely approximate entropy (ApEn), standard deviation (SD), standard error (SE), modified mean absolute value (MMAV), roll-off (R), and zero crossing (ZC) from the epileptic signal. The k-nearest neighbours (k-NN) algorithm is used for the classification of epilepsy then regression analysis is used for the prediction of the epilepsy level at different ages of the patients. Using the statistical parameters and regression analysis, a prototype mathematical model is proposed which helps to find the epileptic randomness with respect to the age of different subjects. The accuracy of this prototype equation depends on proper analysis of the dynamic information from the epileptic EEG.
  3. Kan KW, Sylves P, Nik-Ahmad-Zuky NL, Shatriah I
    Cureus, 2017 Dec 13;9(12):e1942.
    PMID: 29468098 DOI: 10.7759/cureus.1942
    Dengue fever is common in the tropics and its clinical manifestations and complications are well-known. However, dengue-related ocular complications are rare. Here we present a postpartum female who complained of bilateral central scotoma, at five days after the clinical diagnosis of dengue fever. The ocular examination was suggestive of dengue maculopathy and foveolitis. She was treated with a combination of intravenous methylprednisolone and immunoglobulin. The final visual recovery was good.
  4. Thanimalai S, Shafie AA, Ahmad Hassali MA, Sinnadurai J
    Value Health Reg Issues, 2018 May;15:34-41.
    PMID: 29474176 DOI: 10.1016/j.vhri.2017.05.006
    BACKGROUND: Systematic anticoagulation management clinic is recommended to manage patients on chronic warfarin therapy. In Malaysia, the service was introduced as warfarin medication therapy adherence clinic (WMTAC), which is managed by pharmacists with a physician advisory.
    OBJECTIVES: To assess the cost-effectiveness of WMTAC in comparison with usual medical clinic (UMC), which is managed by medical officers in Kuala Lumpur Hospital, a tertiary referral hospital in Malaysia.
    METHODS: Data from a 6-month retrospective cohort study comparing the two clinics and the mean percentages of time in the therapeutic range for the patients were used to estimate the cost-effectiveness. The mean clinic costs were estimated using the time-motion study. A Markov model with a 6-monthly cycle was used to simulate lifetime cost-effectiveness from the perspective of the health care service provider. The base-case analysis assumed a cohort of patients with atrial fibrillation, 57 years of age with comorbid illnesses. The transition probabilities of these clinic outcomes were obtained from a literature search. Future costs and effectiveness were discounted by 3% to convert to present values. All costs were in Malaysian ringgit standardized for the year 2007.
    RESULTS: The mean 6-month treatment cost was lower for the WMTAC, which was significantly lower (P < 0.001). The UMC was found to be dominated by the WMTAC for both intermediate and lifetime analyses. The sensitivity analysis showed that clinic consultation costs had a major impact on the cost-effectiveness analysis.
    CONCLUSIONS: WMTAC is a more cost-effective option than UMC in Kuala Lumpur Hospital.
    Study site: Medical clinic, Hospital Kuala Lumpur, Malaysia
  5. Samuel S, Ahmad RE, Ramasamy TS, Manan F, Kamarul T
    Injury, 2018 Apr;49(4):775-783.
    PMID: 29503013 DOI: 10.1016/j.injury.2018.02.020
    BACKGROUND: It has been previously suggested that the use of regenerative promoters, which include bone marrow-derived mesenchymal stem cells (MSCs) or natural growth factors supplement such as platelet-rich concentrate (PRC) could promote cartilage regeneration. However, the notion that the concurrent use of both promoters may provide a synergistic effect that improves the repair outcome of focal cartilage injury has not been previously demonstrated. This study was thus conducted to determine whether the concomitant use of PRC could further enhance the reparative potential of MSCs encapsulated in alginate transplanted into focal cartilage injury in rabbits.

    METHODS: Artifically created full thickness cartilage defects were made on the weight-bearing region of medial femoral condyles in bilateral knees of New Zealand White rabbits (N = 30). After one month, the right knee was treated with either i) PRC (n = 10), ii) MSCs (n = 10), or, iii) a combination of PRC and MSCs (PRC + MSC) (n = 10), all encapsulated in alginate. The left knee remained untreated (control). Rabbits were sacrificed at 3 and 6 months after treatment. Cartilage tissue regeneration was accessed using ICRS morphologic scoring, histologic grading by O'Driscoll scoring, immunohistochemical staining and quantitative analysis of glycosaminoglycans (GAG) per total protein content.

    RESULTS: At 3 months, transplantation using PRC alone was equally effective as MSCs in inducing the repair of cartilage defects. However, PRC + MSC resulted in significantly higher ICRS and O'Driscoll scores (p 

  6. Qazi HH, Mohammad AB, Ahmad H, Zulkifli MZ
    Sensors (Basel), 2016 Sep 15;16(9).
    PMID: 27649195 DOI: 10.3390/s16091505
    A D-shaped polarization-maintaining fiber (PMF) as fiber optic sensor for the simultaneous monitoring of strain and the surrounding temperature is presented. A mechanical end and edge polishing system with aluminum oxide polishing film is utilized to perform sequential polishing on one side (lengthwise) of the PMF in order to fabricate a D-shaped cross-section. Experimental results show that the proposed sensor has high sensitivity of 46 pm/µε and 130 pm/°C for strain and temperature, respectively, which is significantly higher than other recently reported work (mainly from 2013) related to fiber optic sensors. The easy fabrication method, high sensitivity, and good linearity make this sensing device applicable in various applications such as health monitoring and spatial analysis of engineering structures.
  7. Adzitey F, Ali GR, Huda N, Ahmad R
    3 Biotech, 2013 Dec;3(6):521-527.
    PMID: 28324423 DOI: 10.1007/s13205-013-0115-7
    Salmonella species are important foodborne pathogens that can cause illness and death in humans. The objective of this study was to determine the genetic relatedness of 115 Salmonella strains isolated from ducks and their environment using random amplified polymorphic deoxyribonucleic acid (RAPD). The analysis of Salmonella strains by RAPD produced DNA fingerprints of different sizes for differentiation purposes, and cluster analysis at a coefficient of 0.85 grouped the Salmonella strains into various clusters and singletons. S. Typhimurium were grouped into nine clusters and ten singletons, S. Hadar were grouped into seven clusters and nine singletons, S. Enteritidis were grouped into four clusters and five singletons, S. Braenderup were grouped into five clusters and four singletons, S. Albany were grouped into two clusters and seven singletons, and S. Derby were grouped into two clusters and four singletons at a coefficient of 0.85 with discriminatory index (D) ranging from 0.879 to 0.957. With the exception of S. Typhimurium strains which were grouped into three major groups (genotypes) by RAPD analysis, the rest were grouped into two major genotypes. RAPD was a useful genotyping tool for determining the genetic relatedness of the duck Salmonella strains. Comparison of the genetic relatedness among foodborne pathogens and their sources of isolation are important to trace their source and possibly the source of human infection.
  8. Sim SE, Gunasagaran J, Goh KJ, Ahmad TS
    J Hand Ther, 2018 02 13;32(4):411-416.
    PMID: 29426574 DOI: 10.1016/j.jht.2018.01.004
    STUDY DESIGN: Prospective randomized study.

    INTRODUCTION: Carpal tunnel syndrome (CTS) has been described as the most common compression neuropathy. Many modalities exist for conservative treatment. Efficacy of each modality has been described in the literature. However, the effectiveness of combination of these modalities is not well established. The purpose of this study is to assess the short-term clinical outcome of conservative treatment for CTS comparing orthosis alone with combination of orthosis, nerve/tendon gliding exercises, and ultrasound therapy.

    METHODS: Forty-one patients who presented to Upper Limb Reconstructive and Microsurgery Clinic, University Malaya Medical Centre with CTS and positive electrodiagnostic study were recruited. Fifteen patients had bilateral CTS. Fifty-six wrists were equally randomized to orthosis alone and a combined therapy of orthosis, nerve/tendon gliding exercise, and ultrasound therapy. All patients were required to complete the Boston Carpal Tunnel Questionnaire during the first visit and 2 months after treatment.

    RESULTS: Both the orthosis and combined therapy groups showed a significant improvement in symptoms and function after treatment. The mean difference of symptoms in the orthosis group was 0.53; 95% confidence interval [CI]: 0.23-0.83 (P = .001) and in the combined therapy group was 0.48; 95% CI: 0.24-0.72 (P 

  9. Waheed M, Ahmad R, Ahmed W, Drieberg M, Alam MM
    Sensors (Basel), 2018 Feb 13;18(2).
    PMID: 29438278 DOI: 10.3390/s18020565
    The fabrication of lightweight, ultra-thin, low power and intelligent body-borne sensors leads to novel advances in wireless body area networks (WBANs). Depending on the placement of the nodes, it is characterized as in/on body WBAN; thus, the channel is largely affected by body posture, clothing, muscle movement, body temperature and climatic conditions. The energy resources are limited and it is not feasible to replace the sensor's battery frequently. In order to keep the sensor in working condition, the channel resources should be reserved. The lifetime of the sensor is very crucial and it highly depends on transmission among sensor nodes and energy consumption. The reliability and energy efficiency in WBAN applications play a vital role. In this paper, the analytical expressions for energy efficiency (EE) and packet error rate (PER) are formulated for two-way relay cooperative communication. The results depict better reliability and efficiency compared to direct and one-way relay communication. The effective performance range of direct vs. cooperative communication is separated by a threshold distance. Based on EE calculations, an optimal packet size is observed that provides maximum efficiency over a certain link length. A smart and energy efficient system is articulated that utilizes all three communication modes, namely direct, one-way relay and two-way relay, as the direct link performs better for a certain range, but the cooperative communication gives better results for increased distance in terms of EE. The efficacy of the proposed hybrid scheme is also demonstrated over a practical quasi-static channel. Furthermore, link length extension and diversity is achieved by joint network-channel (JNC) coding the cooperative link.
  10. Mohammed AH, Ahmad MB, Ibrahim NA, Zainuddin N
    Chem Cent J, 2018 Feb 13;12(1):15.
    PMID: 29442180 DOI: 10.1186/s13065-018-0379-4
    BACKGROUND: The incorporation of two different monomers, having different properties, in the same polymer molecule leads to the formation of new materials with great scientific and commercial importance. The basic requirements for polymeric materials in some areas of biomedical applications are that they are hydrophilic, having good mechanical and thermal properties, soft, and oxygen-permeable.

    RESULTS: A series of 3-(trimethoxysilyl) propyl methacrylate/N-vinyl pyrrolidone (TMSPM/NVP) xerogels containing different concentration of ethylene glycol dimethacrylate (EGDMA) as crosslinking agent were prepared by bulk polymerization to high conversion using BPO as initiator. The copolymers were characterized by FTIR. The corresponding hydrogels were obtained by swelling the xerogels in deionized water to equilibrium. Addition of EGDMA increases the transparency of xerogels and hydrogels. The minimum amount of EGDMA required to produce a transparent xerogel is 1%. All the Swelling parameters, including water content (EWC), volume fraction of polymer (ϕ2) and weight loss during swelling decrease with increasing EGDMA. Young's and shear modulus (E and G) increase as EGDMA increases. The hydrogels were characterized in terms of modulus cross-linking density (veand vt) and polymer-solvent interaction parameters (χ). Thermal properties include TGA and glass transition temperature (Tg) enhance by adding EGDMA whereas the oxygen permeability (P) of hydrogels decreases as water content decrease.

    CONCLUSIONS: This study prepared and studied the properties for new copolymer (TMSPM-co-NVP) contains different amounts of (EGDMA). These copolymers possess new properties with potential use in different biomedical applications. The properties of the prepared hydrogels are fit with the standard properties of materials which should be used for contact lenses.

  11. Bahari R, Mohamad Alwi MN, Ahmad MR, Mohd Saiboon I
    Malays Fam Physician, 2017;12(3):2-7.
    PMID: 29527273 MyJurnal
    Introduction: Motor vehicle accidents (MVAs) are daily occurrences in Malaysia but the extent to which victims are psychologically affected is not well known. The objective of this study is to determine the incidence and demographic characteristics of patients with post-traumatic stress disorder (PTSD) due to MVAs at a university hospital in Malaysia.

    Methods: Patients presenting to the emergency department from August to October 2014 due to MVA-related injuries were recruited. After a period of at least one month, they were followed-up and screened using the validated Malay Post Traumatic Stress Disorder Checklist Civilian version. A score of 30 was chosen as the cut-off point for PTSD.

    Results: In total, 112 patients presented to the emergency department following MVAs during the study period. Of these, 60.7% agreed for the follow-up. Among the respondents, the mean age was 26 years, 91.2% were males, 66.2% were married, 85.3% were Malays and 88.3% were Muslims. The calculated incidence of PTSD was 7.4%. There was no significant difference noted between the PTSD and non-PTSD groups.

    Conclusion: A considerable number of MVA victims in Malaysia may develop PTSD after the accident. Further research is needed to explore the factors that contribute or protect to develop the condition.

  12. Sanchez Bornot JM, Wong-Lin K, Ahmad AL, Prasad G
    Brain Topogr, 2018 11;31(6):895-916.
    PMID: 29546509 DOI: 10.1007/s10548-018-0640-0
    The brain's functional connectivity (FC) estimated at sensor level from electromagnetic (EEG/MEG) signals can provide quick and useful information towards understanding cognition and brain disorders. Volume conduction (VC) is a fundamental issue in FC analysis due to the effects of instantaneous correlations. FC methods based on the imaginary part of the coherence (iCOH) of any two signals are readily robust to VC effects, but neglecting the real part of the coherence leads to negligible FC when the processes are truly connected but with zero or π-phase (modulus 2π) interaction. We ameliorate this issue by proposing a novel method that implements an envelope of the imaginary coherence (EIC) to approximate the coherence estimate of supposedly active underlying sources. We compare EIC with state-of-the-art FC measures that included lagged coherence, iCOH, phase lag index (PLI) and weighted PLI (wPLI), using bivariate autoregressive and stochastic neural mass models. Additionally, we create realistic simulations where three and five regions were mapped on a template cortical surface and synthetic MEG signals were obtained after computing the electromagnetic leadfield. With this simulation and comparison study, we also demonstrate the feasibility of sensor FC analysis using receiver operating curve analysis whilst varying the signal's noise level. However, these results should be interpreted with caution given the known limitations of the sensor-based FC approach. Overall, we found that EIC and iCOH demonstrate superior results with most accurate FC maps. As they complement each other in different scenarios, that will be important to study normal and diseased brain activity.
  13. Anis FN, Umat C, Ahmad K, Abdul Hamid B
    Cochlear Implants Int, 2022 Nov;23(6):347-357.
    PMID: 36005236 DOI: 10.1080/14670100.2022.2114583
    OBJECTIVE: This study aimed to compare the error patterns of Arabic phoneme-grapheme correspondence by a group of Malay children with cochlear implants (CIs) and normal hearing (NH) and the effects of the visual graphical features of Arabic graphemes (no-dot, single-dot, and multiple-dots) on the phoneme-grapheme correspondence.

    METHODS: Participants were matched for hearing age (Mean, M = 7 ± 1.03 years) and duration of exposure to Arabic sounds (M = 2.7 ± 1.2 years). All 28 Arabic phonemes were presented through a loudspeaker and participants pointed to the graphemes associated with the presented phonemes.

    RESULTS: A total of 336 and 616 tokens were collected for six children with CI and 11 NH children for each task, i.e., phonemes repetition and phoneme-grapheme correspondence. Both groups found it easier to repeat phonemes than the phoneme-grapheme correspondence. The children with CIs showed more confusion ([ظ, ز, ذ, ض, خ, ب, ه, س, ع, & ث] >10% correct scores) in phoneme-grapheme correspondence than the NH children ([ظ:14%] and [ث: 27%]). There was a significant interaction (p = 0.001) among the three visual graphical features and hearing status (CI and NH).

    CONCLUSION: Our results infer that non-native Malay children with CIs and NH use different strategies to process the Arabic graphemes' visual features for phoneme-grapheme correspondence.

  14. Mohammad N, Ahmad R, Kurniawan A, Mohd Yusof MYP
    Front Artif Intell, 2022;5:1049584.
    PMID: 36561660 DOI: 10.3389/frai.2022.1049584
    BACKGROUND: Forensic odontology may require a visual or clinical method during identification. Sometimes it may require forensic experts to refer to the existing technique to identify individuals, for example, by using the atlas to estimate the dental age. However, the existing technology can be a complicated procedure for a large-scale incident requiring a more significant number of forensic identifications, particularly during mass disasters. This has driven many experts to perform automation in their current practice to improve efficiency.

    OBJECTIVE: This article aims to evaluate current artificial intelligence applications and discuss their performance concerning the algorithm architecture used in forensic odontology.

    METHODS: This study summarizes the findings of 28 research papers published between 2010 and June 2022 using the Arksey and O'Malley framework, updated by the Joanna Briggs Institute Framework for Scoping Reviews methodology, highlighting the research trend of artificial intelligence technology in forensic odontology. In addition, a literature search was conducted on Web of Science (WoS), Scopus, Google Scholar, and PubMed, and the results were evaluated based on their content and significance.

    RESULTS: The potential application of artificial intelligence technology in forensic odontology can be categorized into four: (1) human bite marks, (2) sex determination, (3) age estimation, and (4) dental comparison. This powerful tool can solve humanity's problems by giving an adequate number of datasets, the appropriate implementation of algorithm architecture, and the proper assignment of hyperparameters that enable the model to perform the prediction at a very high level of performance.

    CONCLUSION: The reviewed articles demonstrate that machine learning techniques are reliable for studies involving continuous features such as morphometric parameters. However, machine learning models do not strictly require large training datasets to produce promising results. In contrast, deep learning enables the processing of unstructured data, such as medical images, which require large volumes of data. Occasionally, transfer learning was used to overcome the limitation of data. In the meantime, this method's capacity to automatically learn task-specific feature representations has made it a significant success in forensic odontology.

  15. Oluwasola IE, Ahmad AL, Shoparwe NF, Ismail S
    J Contam Hydrol, 2022 Oct;250:104057.
    PMID: 36130428 DOI: 10.1016/j.jconhyd.2022.104057
    The current toxicity concerns of gadolinium-based contrast agents (GBCAs) have birthed the need to regulate and, sometimes restrict its clinical administration. However, tolerable concentration levels of Gd in the water sector have not been set. Therefore, the detection and speedy increase of the anthropogenic Gd-GBCAs in the various water bodies, including those serving as the primary source of drinking water for adults and children, is perturbing. Nevertheless, the strongly canvassed risk-benefit considerations and superior uniqueness of GBCAs compared to the other ferromagnetic metals guarantees its continuous administration for Magnetic resonance imaging (MRI) investigations regardless of the toxicity concerns. Unfortunately, findings have shown that both the advanced and conventional wastewater treatment processes do not satisfactorily remove GBCAs but rather risk transforming the chelated GBCAs to their free ionic metal (Gd 3+) through inadvertent degradation processes. This unintentional water processing-induced GBCA dechelation leads to the intricate  pathway for unintentional human intake of Gd ion. Hence exposure to its probable ecotoxicity and several reported inimical effects on human health such as; digestive symptoms, twitching or weakness, cognitive flu, persistent skin diseases, body pains, acute renal and non-renal adverse reactions, chronic skin, and eyes changes. This work proposed an economical and manageable remediation technique for the potential remediation of Gd-GBCAs in wastewater, while a precautionary limit for Gd in public water and commercial drinks is advocated.
  16. Chan CE, Ng TJ, Ahmad MK, Mohamad Nor FS
    Case Rep Nephrol Dial, 2022;12(3):201-206.
    PMID: 36465575 DOI: 10.1159/000527248
    Renal involvement in systemic lupus erythematosus is usually exhibited as lupus nephritis, which is a form of immune complex-mediated glomerulonephritis and one of the most severe organ manifestations of systemic lupus erythematosus. The pathogenesis involved glomerular immune complex deposition, which leads to glomerular inflammation and typically shows a "full-house" pattern on immunofluorescence microscopy. Other forms of glomerulonephritis are rarely observed in patients with systemic lupus erythematosus. Pauci-immune crescentic glomerulonephritis is the pattern of injury most commonly observed in patients with antineutrophil cytoplasmic autoantibody-associated glomerulonephritis. The characteristic histological feature of pauci-immune crescentic glomerulonephritis is focal necrotizing and crescentic glomerulonephritis with little or no glomerular staining for immunoglobulin by immunofluorescence microscopy. We report a rare case of antineutrophil cytoplasmic autoantibody-negative pauci-immune crescentic glomerulonephritis in a patient with systemic lupus erythematosus.
  17. Shahdan D, Rosli NA, Chen RS, Ahmad S
    Polymers (Basel), 2022 Nov 18;14(22).
    PMID: 36433138 DOI: 10.3390/polym14225009
    Over the last few decades, processing and compatibility have become challenging and interesting investigation areas of polymer matrix nanocomposites. This study investigated the addition of maleic anhydride (MAH) at different ratios with graphene nanoplatelets (GnPs) in poly(lactic acid)/modified natural rubber/polyaniline/GnP (PLA/m-NR/PANI/GnP) nanocomposites via two processing methods: a two-step technique and a one-pot technique. The former technique involved first preparing a master batch of PLA grafted with MAH, followed by a second step involving the melt blending of the nanocomposite (T1) using MAH-g-PLA. On the other hand, the one-pot technique involved the direct mixing of MAH during the melt-blending process (T2). The mechanical, morphological and thermal properties of the prepared nanocomposites were investigated. The findings showed that adding MAH significantly improved the tensile strength and elongation at break by about 25% for PLA/m-NR/PANi/GnP nanocomposites, with an optimal ratio of 1:1 of MAH-g-PLA to GnP loading using the T1 technique. FTIR analysis confirmed the chemical interaction between MAH and PLA for T1 nanocomposites, which exhibited improved phase morphology with smoother surfaces. MAH-compatibilized nanocomposites had enhanced thermal stabilities when compared to the sample without a compatibilizer. The findings show that the compatibilized PLA nanocomposite is potentially suitable for bio-inspired materials.
  18. Ahmad N, Choy CY, Aris EA, Balan S
    Anesth Analg, 2005 Apr;100(4):987-990.
    PMID: 15781511 DOI: 10.1213/01.ANE.0000147790.76114.3A
    We compared the efficacy of IV fentanyl with IV lidocaine as pretreatment for the prevention of withdrawal response after rocuronium injection. For this prospective, randomized, placebo-controlled, double-blind study we recruited 90 patients aged between 18 and 65 yr, ASA physical status I or II, who had undergone elective surgery requiring general anesthesia and positive pressure ventilation. Patients were randomly allocated to 1 of 3 groups: group F received 2 mL IV fentanyl 50 microg/mL (100 microg), group L received 2 mL of preservative-free lidocaine 2% (40 mg), and group P (placebo) received 2 mL of normal saline. The incidence of withdrawal response after rocuronium was 57%, 30%, and 7% in the placebo, lidocaine, and fentanyl groups, respectively. We found a significant reduction in incidence of withdrawal response in both the fentanyl and lidocaine groups when compared with the placebo group (P < 0.05), with the fentanyl group being most effective (P < 0.05). In conclusion, both fentanyl and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with fentanyl being more effective.
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