Postoperative analgesia in impacted third molar surgery: the role of preoperative diclofenac sodium, paracetamol and lornoxicam

The aim of this study was to compare the postoperative analgesic effects of preoperative intravenous [i.v.] paracetamol, diclofenac sodium and lornoxicam [nonsteroidal anti-inflammatory drugs]. Sixty patients with impacted third molar who underwent surgical removal were randomly allocated into three groups: group P [n=20], group D [n=20] and group L [n=20]. Group P received preoperatively 1 g paracetamol i.v., group D 75 mg diclofenac sodium i.m. and group L 8 mg lornoxicam i.v. Postoperative pain intensity, additional consumption of analgesics postoperatively and postoperative complications were compared among groups. The groups were comparable for pain scores [p>0.05]. Maximum pain scores were recorded in postoperative 4th h in all groups [group L 22, 14-44 mm; group P 24, 13-43 mm; group D 14, 10-24 mm, p=0.117]. Patients experienced high satisfaction scores which were comparable among groups [group L 85, 75-100 mm; group P 87, 70-95 mm; group D 84, 77-98 mm, p=0.457]. Preoperative intramuscular diclofenac, intravenous paracetamol and lornoxicam effectively decreased the pain scores. The patients were satisfied with the three postoperative pain management regimens

Foramen of Vesalius

To investigate the frequency of unilateral or bilateral foramen of Vesalius FV, number of FV present on one side, and presence of a septum on FV. We bilaterally examined, 347 sphenoid bones of collections of the Department of Anatomy, Istanbul Faculty of Medicine, Istanbul University, Istanbul and Dokuz Eylul Faculty of Medicine, Izmir, Turkey in 2007. Of the 347 bilaterally examined skulls, 87 25.1% had bilateral FV, 191 55% specimens did not have any FV on both sides, and 69 specimens 19.9% had unilateral FV 33 skulls had FV on the right side, and the remaining 36 skulls had FV on the left. Of the 156 skulls which had FV, only 4 skulls 3 on the right, one on the left had double FV on the same side. We have not observed any specimens which had 3 or more FV on the same side. Of the 156 skulls which had FV, 11 skulls had a septum on FV, 3 skulls had a septum on FV on the right side, and 6 skulls had a septum on FV on the left side. Two skulls bilaterally had a septum on both sides. We believe that our data about FV will be enlightening not only for anatomists, but also for clinicians

Change of quadriceps angle values with age and activity

The lines connecting the anterior superior iliac spine to the center of the patella and the center of the patella to the tibial tuberosity make the quadriceps angle [Q angle], and this can be used as data for patellar alignment. We undertook this study to provide detailed information about the change of Q angle values with age and activity. The study was conducted on 474 active [AG] [soccer players] and 765 sedentary [SG] boys [N=1239] from the age of 9-19, and the sedentary group also served as control to their age matched active counterparts. The statistical methods used were the student's t-test and the 3 way analysis of variance [ANOVA]. The study was carried out in the laboratories of the Anatomy Departments and School of Physical Education and Sports, Istanbul and Hacettepe Universities between 2001 and 2003. The right and left Q angle values within both groups were statistically insignificant. The comparison of the groups showed a very high level of significant difference between the groups for both knees [AG right Q angle = 14.54 +/- 4.76, SG right Q angle = 17.98 +/- 3.24; AG left Q angle = 14.41 +/- 4.61, SG left Q angle = 18.12 +/- 3.55]. The 3 way ANOVA showed that the age and physical activity had equally highly significant effects on Q angle values with a greater change in the active group's values. We conclude that 1] children and adolescents have greater Q angle values than adults, 2] a change in quadriceps strength and tone, caused by both growth and activity, results in a decrease of the Q angle and 3] activity, particularly playing soccer in our study, has a remarkable effect on the Q angle