ABSTRACT
To conduct a prospective randomized study comparing the analgesic effect of Intravenous Paracetamol with Intravenous Morphine in postoperative pain control of patients undergoing knee arthroscopic surgery as day cases. Eighty four patients were randomised into two groups on the basis of the last digit of their medical number. Odd numbers were given Paracetamol [Group-I] and even Morphine [Group-II]. All patients underwent Examination under Anaesthesia [E.U.A] and knee arthroscopy +/- a partial menisectomy as day cases and had to stay of a minimum of 4 hours post surgery. A standardize General Anaesthesia was given to both groups. An intra-articular injection of 20mls of 0.5% Marcaine was given to all patients. Postoperative pain was assessed up to 4 hours using the Verbal Rating Scale [V.R.S.]. The adverse effects of the drugs were also observed. Of 84 patients, 76 were males and 8 females. The age range was from 18 to 69 years, weighing from 55 to 90kg. Paracetamol [Group-I] had 43 patients and there were 41 patients in the Morphine [Group-II] Group. The results according to VRS, from 0 to 4 hours showed no difference in the analgesic effect of the two groups, but much less adverse effect were noted in Group-I. In our study both intravenous Paracetamol and Intravenous Morphine seems to have the same analgesic effect. However, side effects with Intravenous Paracetamol were much less
ABSTRACT
Background: Off-pump coronary artery bypass B] is an emerging. It is assumed that munition of cardiopulmonary bypass Pli]for coronary artery bypass graftingBG] has the potential for reducing lucrative morbidity. In this study, we cstigated the effect of coronary Miscularization with or without vv.rdiopulmonary bypass on myocardial ,H hernia and neurological outcome
Methods: Forty patients [31 males] with average in undergoing coronary revascularizatipn, median stemotomy,withorwithout utrdiopulinonary bypass were divided into to groups: Group I: 20 patients undergoing OPIAB and group II: 20 patients undergoing B] with CPB. Troponin T [TNT] and CK-MB for detection of myocardial ischemia : performed6.12,24,48,hoursafter anon Hemodynamic changes, heart rate, ,;i blood pressure, central venous pressure,nonary capillarywedgepressureand line index were measured preoperatively postoperatively. Neurological outcome, amount of blood loss and blood or bloodproducts transfusion were also measured. As well as, intubation time, ICU stay were recorded
Results: The results of this study showed significant reduction in myocardial ischemia and infarction post revascularization in group I in comparison to group II, 1 patient in OPCAB group developed ischemic changes with increase TNT and Ck-MB and developed non fetal myocardial infarction [MI] while in group II, four patients developed ischemic changes, three of them were showed elevated Ck-MB and two with elevated TNT concentrations and developed non fetal MLThere was no neurological complication in OPCAB group while in group II one patient was developed delayed recovery and delirium, and another patient was developed cerebral stroke postoperatively. Blood loss and blood transfusion were in a significantly lower with OPCAB group. There were significant shorter intubation time and ICU stay in OPCAB group than in group II
Conclusions: OPCAB can be safely performed in selected patients. Elimination of CPBsignificantly reduce postoperative myocardial ischemia and neurological complications. Prospective randomized trials are need to define better patients selection and long-term benefits of OPCAB