Parecoxib and paracetamol for pain relief following minor day-stay gynaecological surgery.

Paracetamol and non-steroidal anti-inflammatory drugs are often administered for postoperative analgesia. Dilatation and curettage, with or without hysteroscopy, is a common day-stay procedure that is associated with pain that is partly mediated by prostaglandins. This study aimed to investigate the analgesic efficacy of adjunctive paracetamol and parecoxib in this setting. A randomised, blinded, placebo-controlled, single-centre trial was conducted among 240 women undergoing dilatation and curettage. Patients were randomised intraoperatively into one of four groups, to receive either intravenous paracetamol 2 g, intravenous parecoxib 40 mg, both in combination, or placebos, post-induction and with intravenous fentanyl. The primary endpoints were pain score one hour postoperatively and the Overall Benefit of Analgesia Score. There were no statistically significant differences in primary outcomes across groups. The area under the curve for pain scores to two hours postoperatively was significantly lower in the group receiving paracetamol (P=0.018) and the need for rescue analgesia with tramadol was less in the combination group (P=0.02). There were no significant differences in patient satisfaction or recovery. We conclude that paracetamol or parecoxib does not produce a clinically important reduction in pain in this setting. Women having uterine curettage and receiving intravenous fentanyl do not appear to benefit from administration of these non-opioid analgesics.

Electromyographic activity and applied load during high intensity elastic resistance and nautilus machine exercises.

This study was designed to quantify and compare Electromyographic activity (EMG) and applied load in quadriceps muscle within performing high intensity knee extension exercises by Elastic Resistance (ER) and Nautilus Machine (NM). Sixteen male and female subjects (22.4 ± 4.7 yrs) completed 8 RM seated knee extension by NM, elastic tubing with original length (E0) and elastic tubing with 30% decrement of original length (E30). The mean value of EMG and external force were calculated and synchronized across various segments of motion for the three modes of training. The results demonstrated that in the early concentric and late eccentric segments of contraction, NM elicited significantly higher muscle activation than both E30 and E0 (p < 0.05). However, in the mid-concentric and mid-eccentric as well as late concentric and early eccentric segments no significant differences were observed between NM and E30. These findings supported the approach that developing external recoil of force in ER device by reducing 30% of initial length of elastic material can offer similar neuromuscular activation compared with NM. On this basis, E30 can be suggested as an affordable and non-gym based exercise device which has the capacity to provide an appropriate high resistance stimulus to meet the training requirement of athletes.