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

Anesthetic management of diabetic patients undergoing major surgery using glucose insulin potassium infusion a study of thirty cases

Thirty diabetic patients undergoing major elective surgery were studied to assess the effectiveness of a regimen of glucose - insulin - potassium infusion at the Aga Khan University Hospital, Karachi. Out of the 30 patients studied, 25 were non insulin dependent and 5 insulin dependent. During surgery 24 out of 30 patients [80%] had acceptable glycaemic control i.e. mean blood glucose levels in the range of 90-216 mg/100 ml with neither clinical nor biochemical evidence of hypoglycemia or hyperglycaemia. Post operatively, the mean blood glucose level on the day of operation was acceptable in 19 patients [63.33%]. During this study, no patient had clinical or biochemical hypoglycemia, neither was there any incidence of serious morbidity or mortality attributable to problems with diabetic control. Glucose insulin potassium infusion was found to be satisfactory for managing diabetics during major surgery