A Comparative Efficacy of Propacetamol and Ketorolac in Postoperative Patient Controlled Analgesia

BACKGROUND: Ketorolac has been used as a postoperative analgesia in combination with opioids. However, the use of ketorolac may produce serious side effects in vulnerable patients. Propacetamol is known to induce fewer side effects than ketorolac because it mainly affects the central nervous system. We compared the analgesic effects and patient satisfaction levels of each drug when combined with fentanyl patient-controlled analgesia (PCA). METHODS: The patients were divided into two groups, each with n = 46. The patients in each group were given 60 mg of ketorolac or 2 g of propacetamol (mixed with fentanyl) for 10 minutes. The patients were then given 180 mg of ketorolac or 8 g of propacetamol (mixed with fentanyl and ramosetron) through PCA. We assessed the visual analogue pain scale (VAS) at the time point immediately before administration (baseline) and at 15, 30, and 60 minutes, and 24 hours after administration. Also, the side effects of each regimen and each patient's degree of satisfaction were assessed. RESULTS: There was a significant decline in the VAS score in both groups (P < 0.05). However, there were no significant differences in the VAS scores between the groups at each time point. Satisfaction scores between the groups showed no significant difference. CONCLUSIONS: The efficacy of propacetamol is comparable to that of ketorolac in postoperative PCA with fentanyl.

Increases in the Proteins Modified by Malondialdehyde and Hydroxynonenal in the Hippocampus of Prion-Infected Mice

Prion diseases, also termed transmissible spongiform encephalopathies (TSEs), are rare and fatal neurodegenerative conditions that affect both humans and animals. Although there is increased evidence that oxidative stress plays an important role in the pathogenesis of these diseases, the direct relationship between an accumulation of abnormal prion protein (PrP(Sc)) and the occurrence of oxidative stress has not been studied. In the present study, we have investigated the cellular localization of proteins modified by lipid peroxidation end products and its correlation with PrP(Sc) accumulation in the brain of mice infected with the ME7 prion strain. Intense immunostaining of malondialdehyde (MDA)- and hydroxynonenal (HNE)-modified proteins were observed in the hippocampus of prion-infected mice. In serial section study, we found that these immunoreactivities were co-localized with glial fibrillary acidic protein (GFAP)-positive astrocytes as well as with PrP(Sc). These results clearly indicate that the heightened oxidative stress in the form of lipid peroxidation is closely associated with PrP(Sc) accumulation in astrocytes of prion-infected mice.