[Co-analgesic effect of ketorolac after thoracic surgery]

Thoracotomies are painful surgical procedures and adequate pain relief is associated with improved respiratory function and fewer respiratory complications. After thoracotomy for lung resection, patients received morphine-based patient-controlled analgesia [PCA]. Three groups were propectively and randomized investigated: patients receiving preemptive ketorolac, those given postoperative ketorolac and controls. No differences among groups were found for demographic data, anesthesia and surgery durations, or for the amounts of anesthesia drugs administered. The blood loses were also comparable: 565 +/- 374 ml for the preemptive ketorolac group, 749 +/- 491 ml for the postoperative ketorolac group and 674 +/- 323 ml for the controls. At 48 h after surgery, compared to control, morphine consumption was 36% lower for the preemptive ketorolac group and 17% lower for postoperative ketorolac group [p< 0.05]. No statistically significant differences were observed for pulmonary function tests. These results suggest that non-steroidal anti-inflammatory drugs can reduce the opioid requirements after thoracic surgery but do not improvement lung function

[ importance of nutritional support for head injured patients]

Serious head injuries lead to any metabolic disorders such as, in particular a protein types cataolism and immunodepression. Early nutritional support for the patient in this case is definitely beneficial. It should be started as soon as the patient is out of danger. Enteral feeding should be preferred to parenteral feeding. In case of disorder of the bavel habit or of malabsorption, parenteral. protein-energy intake should be prescribed for a short period. In case of neuroagression, a suppementary intake of amino-acids [glutamine, arginine] seems beneficial for a betten immuniy defence system