Comparison of intravenous ketorolac with diclofenac for postoperative analgesia

To compare analgesic effect and complications of non - steroidal anti-inflammatory drugs [NASIDs], ketorolac versus diclofenic in prevention of pain after laparoscopic cholecystectomy. Quasi-experimental study. The Department of Anesthesiology and Surgical Intensive Care Unit, Dow Medical College, Karachi from March 2003 to March 2004. Sixty patients, ASA physical status I and II were selected to received either ketorolac 30 mg intravenous [group A] or diclofenic 75 mg intravenous [group B], after general anesthesia induction and before surgical incision. In ketorolac group same dose repeated three times daily for 24 hours. The diclofenic group received diclofenic 75mg 12 hourly for 24 hours. Analgesic effect assessed by intensity of pain postoperatively using visual analogue scale, 0 mean no pain and 10 most severe pain. Rescue analgesic nalbuphine was administered if needed. Both groups required rescue analgesic 0.1mg/kg nalbuphine boluses postoperatively. Higher nalbuphine consumption was noted compared to diclofenic group until 12 hours, which is statistically significant [P value < 0.05]. Side effects were almost similar in both groups. Ketorolac and diclofenic are insufficient alone for analgesia after laparoscopic cholecystectomy; the total nalbuphine consumption was less in ketorolac group

Is mallampati scoring relevant in patients with oral cancers?

To assess the feasibility of successful endotracheal intuhation in patients with oral cancer with a Mallampati score of 4 with reasonable mobility of temporo-mandibular and atlantoaxial joints. ENT department, Civil Hospital Karachi, from March 2005 to March 2007. 25 patients, with orofacial cancers were chosen in which the Mallampati score was 4 and tracheal intubation was expected to be very difficult. In this study out of twenty five patients 24 pts [96%] were intubated successfully with Macintosh laryngoscope. Patients having Mallampati class 4 have a reasonable chance of undergoing successful endotracheal intubation provided their temporo-mandibular joints and atlantoaxial joints are mobile. Key Words: .Endotracheal intubation, Mallampati scoring