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Register a new userComparative Study Between IV Ketorolac and Postoperative Inguinal Block for Postoperative Analgesia
دراسة مقارنة بين الكيتورولاك وريدياً و الحصار المغبني في نهاية العمل الجراحي للتسكين بعد الجراحة
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إن الألم المزمن بعد جراحة رتق الفتق الإربي يحدث عند 12% - 54 % من المرضى. لذلك استخدم حصار العصبين الحرقفي الإربي (IG) و الحرقفي الخثلي ( IH ) لكثير من المرضى عند إجراء هذه الجراحة. كما يستطب استخدام الكيتورولاك مدة قصيرة لا تزيد على خمسة أيام للتسكين، و إن الجرعة المنصوح بها من الكيتورولاك تؤدي إلى التأثير المسكن نفسه الحاصل بعد 6 - 12 ملغ من المورفين، و المعطى بالطريقة نفسها، كما أن بدء تأثيره المسكن مشابه للمورفين، و لكَّن للكيتورولاك تأثيراً مسكناً مدة أطول ( 6 - 8 ) ساعات. ما أفضل طريقة لتسكين الألم بعد الجراحة المغبنية؟. و هل هناك أية فروق بين حصار الأعصاب الإربية ( IG – IH ) و استخدام الكيتورولاك وريدياً للتسكين بعد الجراحة المغبنية من ناحية كفاية التسكين و الحركة الباكرة و الاختلاطات الحادثة بعد الجراحة ؟.
chronic pain after inguinal hernia repair is an adverse outcome that affects about 12 % to 54 % of patients. Ilioinguinal and iliohypogastric ( IG – IH ) nerve block has been widely used in patients undergoing inguinal hernia repair. Ketorolac is indicated for the short term (less than 5 days)management of pain and appears to be particularly useful in the immediate postoperative period. A standard dose of Ketorolac provides analgesia equivalent to 6 – 12 mg of morphine administered by the same route. The interval to onset is also similar to morphine, but Ketorolac has a longer duration of action (6 – 8 h). what is the best method for pain management after inguinal procedures? Is there any difference between (IG – IH) nerve block, and Ketorolac IV postoperatively (pain scores, early movement, nausea, vomiting ...)?
References used
Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. Br J Surg. 2005 Jul;92(7):795-801
Poobalan AS, Bruce J, Smith WC, King PM, Krukowski ZH, Chambers WA. A review of chronic pain after inguinal herniorrhaphy. Clin J Pain. 2003 Jan-Feb; 19(1):48-54
JanneRomsing, Steffen Mysager, Peter Vilmann, JesperSonne,. Postoperative analgesia is not different after local VS systemic administration of meloxicam in patients undergoing inguinal hernia repair. Can J Anesth;(2001)48:978-984
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Introduction: Ileus commonly occurs after abdominal surgery, and is associated
with complications and increased length of hospital stay. Post-operative ileus (POI) is an
important reason for remaining patients not permit oral (NPO) in post-operativ
e period.
The tradition was that when patients passed flatus, they were ready to consume a liquid
diet, and then a solid food diet was gradually introduced. This approach was taken to avoid
aspiration, gastric and intestinal distension, and anastomotic dehiscence. Although studies
demonstrated that the conventional strict feeding regimens were not necessary, many
surgeons still hesitated to allow early oral feeding. There has been concern that early oral
intake would result in vomiting and severe paralytic ileus with subsequent aspiration
pneumonia, wound dehiscence and anastomotic leakage. This belief has become surgical
dogma, unsupported by scientific evidence. Aim: to investigates the effect of early oral
postoperative carbohydrates feeding on postoperative outcome. Material and
methods: forty abdominal surgery patients were randomly assigned to early oral
postoperative feeding group (20) or traditional feeding group (20). In the early feeding
group (study group), patients were initially started on clear fluid only 16 h after surgery
and progressed to liquids (after 24 h) and then soft and regular diet in next day (after 48 h).
In the post-operative period, the patients were visited each 12 h and clinical signs and
symptoms such as, time of passed flatus and moved their bowels, nausea and vomiting, and
the length hospital stay were assessed. Conclusions: This study showed that early oral
postoperative carbohydrates feeding group passed flatus and moved their bowels much
sooner than the control group thus reducing the duration of POI and hospital stay, but there
is no increase in occurrence of of nausea and vomiting between tow groups.
Uterine curettage is considered the fundamental procedure in the treatment of
abortions especially in complete and missed abortions in many counties despite the availability of many alternative methods to treat these cases. It is also widely used as
a diagnostic means to diagnoses the endometrial abnormalities which cause abnormal uterine bleeding. This research aims to figure out complications rate which occur during uterine curettage and the subsequent complications rate and to identify the most important causes of them for the purpose of knowing the efficiency and the safety of the diagnostic and therapeutic uterine curettage.
Introduction: Ileus commonly occurs after abdominal surgery, and is associated
with complications and increased length of hospital stay (LOHS). Traditionally, preoperative
practice has been to fast the patient for up to 12 h prior to surgery. The r
ationale
for this is to reduce gastric acidity and volume with a consequent decrease in the risk of
gastric content aspiration during surgery. However, A Cochrane review found no increased
risk of aspiration in patients who were allowed fluids 2–3 h prior to surgery compared to
patients having undergone a traditional fasting period .. A carbohydrate-rich beverage
given before anaesthesia and surgery alters metabolism from the overnight fasted to the fed
state. This reduces the catabolic response (insulin resistance) after operation, which may
have implications for postoperative recovery. Aim : to investigates the effect of
preoperative carbohydrate treatment on postoperative ileus in adult patients undergoing
abdominal surgery. Material and methods: fifty abdominal surgery patients were
randomly assigned to preparation with a 12.5% carbohydrate drink (CHO) (25), or
overnight fasting group (25). The CHO group were given 600 mL to drink on the evening
before and 400 mL on the morning of surgery. The patients' complains of nausea and
vomiting was noted, the length hospital stay and the duration of postoperative ileus (POI),
was measured in tow groups. Conclusions: This study showed that pre-operative
carbohydrate drink may be used safely and also improves patient's comfort as decrease rate
of nausea and vomiting and reduce the length of hospital stay in patients undergoing
abdominal surgery.
intraoperative penile engorgement because of caudal epidural block may result
in tension on surgical sutures and alter surgical outcome
Aim & objective: to compare between the effect of penile block &caudal epidural block on the quality of
analges
ia & surgical outcome following hypospadias repair.
Alleviating pain in children is one of the most exciting and rewarding of
professional activities . pediatric regional anesthesia is receiving its deserved attention as an excellent
technique for a balanced intraoperative anesthesia as well as post
operative analgesia .
Continuous caudal block provides adequate duration of analgesia, not only for lower limb and lower
abdominal surgeries, but also for upper abdominal and thoracic surgery , conserving the haemodynamic
stability .
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