Treatment with paracetamol, ketorolac or etoricoxib did not hinder alveolar bone healing: a histometric study in rats

Prostaglandins control osteoblastic and osteoclastic function under physiological or pathological conditions and are important modulators of the bone healing process. The non-steroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX) activity and consequently prostaglandins synthesis. Experimental and clinical evidence has indicated a risk for reparative bone formation related to the use of non-selective (COX-1 and COX-2) and COX-2 selective NSAIDs. Ketorolac is a non-selective NSAID which, at low doses, has a preferential COX-1 inhibitory effect and etoricoxib is a new selective COX-2 inhibitor. Although literature data have suggested that ketorolac can interfere negatively with long bone fracture healing, there seems to be no study associating etoricoxib with reparative bone formation. Paracetamol/acetaminophen, one of the first choices for pain control in clinical dentistry, has been considered a weak anti-inflammatory drug, although supposedly capable of inhibiting COX-2 activity in inflammatory sites. OBJECTIVE: The purpose of the present study was to investigate whether paracetamol, ketorolac and etoricoxib can hinder alveolar bone formation, taking the filling of rat extraction socket with newly formed bone as experimental model. MATERIAL AND METHODS: The degree of new bone formation inside the alveolar socket was estimated two weeks after tooth extraction by a differential point-counting method, using an optical microscopy with a digital camera for image capture and histometry software. Differences between groups were analyzed by ANOVA after confirming a normal distribution of sample data. RESULTS AND CONCLUSIONS: Histometric results confirmed that none of the tested drugs had a detrimental effect in the volume fraction of bone trabeculae formed inside the alveolar socket.

Studies on the potentiation analgesic effect of phenytoin and ketorolac with pelitazocine using albino mice by eddy's hot plate method

The analgesic activity was tested by Eddy's hot plate method in albino mice using combination of Pentazocine [1 mg/kg] with Phenytoin [10.20 mg/kg] and Pentazocine [1 mg/kg] with Ketorolac [10.20 mg/kg] was given by intra-peritoneal administration, The results showed a significant increase in reaction time [analgesia] in albino mice and hence the present study indicates that combination of Phenytoin and Ketorolac with Pentazocine has significant prolonged analgesic effect as compared with analgesic effect produced by Pentazocine alone

Intrathecal ketorolac injection in albino rats; pharmacological and histological study

Ketorolac tromethamine is a potent injectable non-steroidal anti-inflammatory drug [NSAID]. Ketorolac provides successful analgesia after intrathecal or epidural injection. It is frequently used to manage post-operative pain, cancer pain, and arthritis either intrathecally, or intramuscular. However, its long term administration could induce renal toxicity and/or gastro-intestinal ulceration. The aim of this study was to assess the analgesic potency of ketorolac after intrathecal injection. Also, we aimed to study the histological effect of ketorolac on the spinal cord and the duodenum after treatment in an animal model. 40 adult male albino rats, weighing 250-350 gm, were used and divided into 4 groups, 10 rats each. Group S [control] received 10 microl normal saline intrathecally, group K50 received 50microg ketorolac intrathecally, group K50 + omeprazole [proton pump inhibitor] received 50microg ketorolac intrathecally plus 0.2 mg omeprazole orally, and finally, group K100 received 100microg ketorolac intrathecally. All animals were treated for four successive days. The rat tail flick latency was longer in K50, K50 + omeprazole, and K100 groups when compared to normal control [P = 0.002]. Also, the hind-paw withdrawal latency was longer in treated groups when compared to those of the control group [P = 0.0001]. Moreover, K50 group showed decreased phase II response by 61%, K50 + omeprazole group showed decreased phase II by 62%, while K100 group showed decreased it by 76%. Histological examination revealed no changes in the spinal cord of all treated animals. Also, examination of the duodenum showed normal duodenal mucosa in group K50 and those of group K50 + omeprazole. On the other hand, cellular infiltration as well as destruction of the mucous acini have been noticed in the duodenum of K100 group. Ketorolac could be a good alternative drug used intrathecally to manage pain

Analgésicos no opioides en dolor postoperatorio pediátrico / Analgesic not opioids in pediatric postoperative pain

El dolor postoperatorio es todavía subvalorado en la población pediátrica. Por otro lado, entre las publicaciones que abordan el tema del dolor postoperatorio solo un 10 por ciento de ellas incluye a la población menor de 15 años. Las alternativas terapéuticas en base a analgésicos no opiaceos es restringida en niños, ya que sólo un 20 por ciento del total de las drogas disponibles en el mercado ha probado su eficacia y seguridad en esta población. un analgésico antiguo es el acetaminofeno, acumulando la mayor cantidad de estudios. Los antinflamatorios no esteriodales (AINEs) han ganado popularidad en el manejo del dolor postoperatorio pediátrico. El objetivo de esta revision es determinar cuáles son las indicaciones y las dosis mas racionales y seguras para el tratamiento del dolor agudo en niños.

Postoperatory pain is still subvaluated in pediatric population. On the other hand, only 10 percent of publications discussing postoperatory pain subjects includes a population under age 15. Therapeutic alternatives based on nonopiate analgesics are restrained for children as only 20 percent of the total available drugs in the market has proven their efficacy and safety in children. An old analgesic is acetaminophen, which accumulates most part of studies. Nonsteroidal antinflammarory drugs (NSAI) are gaining popularity to manage postoperatory pain in children. The objective of this revision is to determine the most rational and safest indications and dosages when treating acute pain in children.

Comparison of ketorolac with morphine for Intra-operative analgesia in patients undergoing total abdominal hysterectomy

To compare ketorolac 0.35 mg.kg-1 with morphine 0.1 mg.kg-1 for hemodynamic stability, efficacy of analgesia and incidence of side effects in patients undergoing elective total abdominal hysterectomy. Fifty ASA I and II patients, were enrolled in a prospective, randomized and double blind study. They were divided in two equal groups. Group K received Inj. Ketorolac 0.35 mg.kg-1 while group M received Inj. Morphine 0.1 mg.kg-1 5 minutes before induction of anaesthesia. Hemodynamic responses to laryngoscopy, endotracheal intubation, and surgical incision were noted. Data was entered and analysis was done using SPSS version 10.0. Student-t test and comparison of proportions were done where required. ANOVA was done and a p - value of <0.05 was considered statistically significant. There was a significant rise in heart rate, systolic, diastolic and mean arterial pressure in ketorolac group [K] as compared to baseline values at points of endotracheal intubation and surgical incision. Patients in Morphine group [M] showed a significant increase in heart rate only. There was no statistically significant difference between the two groups for supplemental analgesia requirement Intraoperatively and postoperatively. Complications seen with group K were increased surgical wound bleeding in 2 patients [8%], nausea and vomiting in 4 patients [16%] while in group M there was nausea and vomiting in 5 patients [20%], and respiratory depression in 1 patient [4%]. Although hemodynamic stability at points of painful stimulation was lower in patients given ketorolac as compared to morphine, Ketorolac has a place in the intraoperative pain relief in Pakistan and other developing countries where availability of powerful narcotics is erratic