ABSTRACT
Background-In preemptive analgesia, the analgesic treatment is started before and is operational during the surgical procedure so that the physiological consequences of nociceptive transmission are reduced. Because of this protective effect on nociceptive pathways, preemptive analgesia decreases the incidence of hyperalgesia and allodynia after surgery.Methods-This Hospital based, prospective, randomized, double blind, comparative study was conducted in Department of Anaesthesiology, Sawai Man Singh Medical College after obtaining approval from Institutional Ethics Committee and Research Review Board and written informed consent from all the patients.Results- The mean duration of analgesic was 4.97 ± 2.98 hrs in group Aafter which first rescue analgesic was required in group A, 6.49±2.98 hrs in group B and 7.26±2.51 hrs in group C. The mean duration of analgesia after which second rescue analgesic was required was 9.77±1.95 hrs for group A, 13.36±5.21 hrs for group B and 13.13±4.15 hrs for group C. The mean duration of analgesia after which third rescue analgesic was required was 15.43±3.58 hrs for group A, 15.94±3.42 hrs for group B and 17.25±0.35 hrs for group C.Conclusion-We conclude that pregabalin 75 mg is better drug for preemptive analgesia and it can be used safely as a part of multoimodal analgesia regimens.
ABSTRACT
Objectives: The objective of this study was to determine the diagnostic accuracy of clinical examination ,computed tomography [CT], neck ultrasound [US], thyroid scintigraphy [SC], and fine needle aspiration cytology [FNAC] as a different diagnostic tools for diagnosis of cancer thyroid gland in correlation to the final histopathological examination
Patients and Methods: From a series of 60 patients with different thyroid diseases, this study was conducted on 18 patients [15 females and 3 males with age range from 41 to 63 years] diagnosed clinically and proved histopathologically as cancer thyroid gland. All patients were subjected to full history taking, complete clinical examination, computed tomography [CT], neck ultrasound [US], thyroid scintigraphy [SC] and fine needle aspiration cytology [FNAC]. All the patients with malignant cytological evaluation underwent total thyroidectomy, with selective lateral neck lymph node dissection, for patients with palpable cervical lymphadenopahty, postoperatively histopathological examination of the operative specimens were done. The accuracy, of clinical examination, computed tomography, neck ultrasound, thyroid scintigraphy, and fine needle aspiration cytology, in diagnosis of cancer thyroid was estimated in correlation to the final histopathological examination
Results: The results showed that, the diagnostic accuracy of fine needle aspiration cytology [FNAC] in diagnosis of cancer thyroid gland was 88.9%, while the diagnostic accuracy of computed tomography [CT] was 76% where the diagnostic accuracy of neck ultrasound and clinical examination were 72%, and finally the diagnostic accuracy of scintgraphy was 55.6%
Conclusion: Fine needle aspiration cytology is a safe, cost-effective, sensitive and still the most accurate diagnostic tool in diagnosis of malignant thyroid lesions in clinically suspected cases [cases with regional lymphadenopathy, hoarseness of voice, history of rapid tumour growth, hard and fixed tumour and cases with tumour size >4cm], while CT and sonography, had a nearly similar results in detection of the thyroid malignancy. It is suggested that sonography, is a useful adjunctive test after detection of thyroid lesions on CT