ABSTRACT
Background and aims: Wound infiltration as a pre-emptive measure to relieve post-operative pain is a common practice following laparoscopic procedures. The addition of adjuvants like opioids to local anesthetics can facilitate the prolongation of postoperative analgesia. Our primary aim was to compare the analgesic efficacy of peri-portal infiltration of Ropivacaine alone versus Ropivacaine with Fentanyl in patients undergoing laparoscopic operations. Methods: The study was conducted on 80 ASA physical status I and II patients, aged 18 to 65 years, undergoing surgical procedures under general anesthesia. Group R was infiltrated with Ropivacaine (0.5%) (18ml+2ml saline) while in Group RF, Ropivacaine(18ml) with Fentanyl 2ml (100礸)] was infiltrated around ports, before wound closure. At the end of the surgery, one of our study drug solutions was infiltrated, to which the patient as well as the assessor were blinded. Postoperative pain was assessed by the VAS (visual analog scale) score. Injection Tramadol 100mg was given as a rescue analgesic if the VAS score was ? 3. Student抯 t-test and Fischer抯 exact test were applied for continuous and categorical variables; Kruskal Wallis and Mann Whitney U test for nonparametric data. The entire statistical analysis was done using STATA 13[ STATA CORP. TEXAS, USA] software. Results: The mean duration of analgesia was significantly longer in group RF, with a requirement of fewer doses of rescue analgesics, compared to group R. Conclusion: The addition of Fentanyl to Ropivacaine for periportal infiltration was found to be superior to Ropivacaine alone in providing effective postoperative analgesia as well as reducing the requirement of rescue analgesics.
ABSTRACT
Background:Thrombocytopenia refers to abnormal decrease in platelet count in an individual. The condition may rise at different grades of severity in cancer patients under chemotherapy. In most of the cases, thrombocytopenic condition of cancer patient becomes a major therapy limiting factor. Generally, the treatment of thrombocytopenia lies in dose reduction and/or dose delay but this may adversely affect the treatment plan of cancer. Therefore, managing chemotherapy induced thrombocytopenia is still a challenge. This study was conducted to examine the platelet count improving effect of marketed product UPLAT® (Carica papayaleaf extract + Tinospora cordifoliaextract) in cancer patients with chemotherapy induced thrombocytopenia (CIT).Methods:Fourty (40) subjects were recruited as „case? and twenty (20) as „control?. „Cases? were cancer patients with chemotherapy induced thrombocytopenia. UPLAT® containing following active ingredients;Carica papayaleaf extract: 350mg (standardized to 2% flavonoids)and Tinospora cardifoliaextract: 150mg (standardized to 3% bitters) was given twice daily (2units each) for 10 consecutive days. Platelet count was observed at baseline and day 15 (end of the study). Then pre and post-treatment platelet counts were compared individually in both arms by statistical tests. Response was evaluated in fourty (40) „cases? and twenty „control?y.Results:Mean change for platelet count in case group (93990.00±63896.73) was much higher than control group(27600.00±29758.42).No adverse events with the treatment were observed. Conclusions: This study proves the effectiveness of platelet booster UPLAT® (combination of Carica papayaleaf extract and Tinospora cordifolia) as it significantly increased thrombocytes/platelet count in post-chemotherapy cancer patients.