randomized, clinical trial of ketorolac tromethamine vs ketorolac trometamine plus complex B vitamins for cesarean delivery analgesia

Ketorolac is widely used for postoperative analgesia in patients who undergo cesarean delivery. In countries where the use of opioids is considerably restricted, alternatives to narcotics are required. We hypothesize that the addition of complex B synergize the analgesic effect of ketorolac in postoperative cesarean patients, thus requiring a smaller dose of the anti-inflammatory agent, and therefore decreasing the potential side effects of ketorolac. A randomized clinical trial with 100 patients undergoing a primary elective cesarean delivery enrolled in the study. Pain was assessed in the recovery room and then they were randomized to receive ketorolac 30 mg intramuscular [i.m.] or 15 mg of ketorolac plus complex B vitamin [CBV]. The pain score with an analog scale was assessed 1, 2, 6, 12, 18, and 24 h after the baseline. The student's t test was performed to compare the demographic differences between the 2 means.100 patients were included in the study, showing no statistical differences in the demographics. The patient's pain score at 1, 2, 6, 12, 18 and 24 hours showed no statistical differences between the control group [ketorolac 30mg] compared to the group of ketorolac 15mg and complex B vitamins. No changes in the coagulation studies were found in both groups. The present study demonstrates that ketorolac 30 mg and ketorolac 15 mg plus complex B vitamins can provide acceptable analgesia in many patients with severe pain

Seguimiento de neoplasias del trofoblasto mediante radioinmunoanalisis del fragmento carboxiterminal de beta-coriogonadotropina (COOH-beta-HCG-RIA) en orina. / Monitoring of trophoblastic neoplasms through radioimmunoassay of the urinary carboxy-terminal fragment of beta-choriogonadotropin (COOH-beta-HCG-RIA)

Se empleo un radioimunoanalisis que detecta los niveles en orina del fragmento carboxiterminal de la subunidad beta de gonadotropina corionica (COOH-beta-HCGRIA) como metodo de seguimiento en mujeres con neoplasias del trofoblasto, y se comparo con el radioinmunoanalisis de la subunidad beta de HCG en suero. El sistema de COOH-beta-HCG-RIA demostro una eficiencia mayor para detectar concentraciones minimas de HCG que el radioinmunoanalisis de la subunidad beta intacta (beta-HCG-RIA) en suero. En tres mujeres que habian recibido quimioterapia y que llegaron a cursar con negatividad por el sistema beta-HCG-RIA, fue posible predecir su reactivacion por COOH-beta-HCG-RIA. En una mujer cuya enfermedad remitio, los niveles urinarios de HGC disminuyeron progresivamente hasta alcanzar los limites observados en individuos normales, manteniendose asi hasta donde se prosiguio su control. Se concluye que el COOH-beta-HCG-RIA en orina es un metodo altamente sensible y confiable para detectar HCG en el control de enfermedades persistentes del trofoblasto