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Comparative 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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 Publication date 2013
and research's language is العربية
 Created by Shamra Editor




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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 ...)?


Artificial intelligence review:
Research summary
تتناول هذه الدراسة مقارنة بين تأثير الكيتورولاك الوريدي وحصار الأعصاب المغبنية باستخدام الماركائين في تسكين الألم بعد جراحة الفتق الإربي. شملت الدراسة 61 مريضًا تتراوح أعمارهم بين 16 و45 عامًا، وتم تقسيمهم عشوائيًا إلى مجموعتين: مجموعة تلقت الكيتورولاك وريدياً ومجموعة أخرى تلقت حصار الأعصاب المغبنية بالماركائين. تم تقييم شدة الألم وكفاية التسكين باستخدام مقياس الألم البصري (VAS) ومقياس كفاية التسكين (PRS). أظهرت النتائج أن كلا الطريقتين فعالتين في تسكين الألم، ولكن حصار الأعصاب المغبنية بالماركائين كان أفضل من حيث القدرة على الحركة المبكرة والخروج من المستشفى بوقت أقل. لم يحدث غثيان أو إقياء في مجموعة الماركائين، بينما حدث إقياء عند مريض واحد في مجموعة الكيتورولاك. الاستنتاج الرئيسي هو أن حصار الأعصاب المغبنية بالماركائين يفضل على الكيتورولاك الوريدي لتسكين الألم بعد الجراحة المغبنية بسبب تحسينه للقدرة على الحركة المبكرة وتقليل مدة البقاء في المستشفى.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تقدم مقارنة مفصلة بين طريقتين شائعتين لتسكين الألم بعد جراحة الفتق الإربي. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبياً (61 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم تناول تأثيرات طويلة الأمد لكل من الطريقتين، حيث ركزت الدراسة فقط على فترة الـ 24 ساعة الأولى بعد الجراحة. ثالثاً، كان من الممكن أن تكون الدراسة أكثر شمولية إذا تم تضمين مجموعة أكبر من المرضى ومن مختلف الأعمار والظروف الصحية. أخيرًا، كان من المفيد تضمين تقييمات إضافية مثل جودة الحياة بعد الجراحة وتأثيرات الألم المزمن.
Questions related to the research
  1. ما هي الطرق المستخدمة في الدراسة لتسكين الألم بعد جراحة الفتق الإربي؟

    تم استخدام طريقتين: الكيتورولاك الوريدي وحصار الأعصاب المغبنية باستخدام الماركائين.

  2. ما هي النتائج الرئيسية للدراسة؟

    كلا الطريقتين فعالتين في تسكين الألم، ولكن حصار الأعصاب المغبنية بالماركائين كان أفضل من حيث القدرة على الحركة المبكرة والخروج من المستشفى بوقت أقل.

  3. هل كان هناك أي اختلاف في حدوث الغثيان أو الإقياء بين المجموعتين؟

    لم يحدث غثيان أو إقياء في مجموعة الماركائين، بينما حدث إقياء عند مريض واحد في مجموعة الكيتورولاك.

  4. ما هي الفائدة الرئيسية لاستخدام حصار الأعصاب المغبنية بالماركائين مقارنة بالكيتورولاك الوريدي؟

    الفائدة الرئيسية هي تحسين القدرة على الحركة المبكرة وتقليل مدة البقاء في المستشفى.


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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