Comparison between Infusion Pumps: Fentanyl/Ketamine and Fentanyl/Paracetamol in Pain control Following Tight and Leg Surgeries

Background: Adjuvants such as ketamine, promethazine and paracetamol could bring up patients satisfaction and control harmful effects of opioids besides lessening their needed doses, as seen by fentanyl/paracetamol and fentanyl/ketamine combination before. The current study headed to compare paracetamol and ketamine in addition to fentanyl applied by infusion pumps in order to pain relief following major surgery.Methods: Through a double blinded randomized clinical trial, patients between18 and 65 with elective surgery for tight or leg fractures with ASA Class 1 and 2 referring to a university hospital in Arak, a town in central region of Iran, were recruited and used infusion pump for their postoperative pain control. The participants were divided into cases and controls regarding using ketamine/fentanyl (KF) or paracetamol/fentanyl (PF) infusion pumps.Results: The mean pain score was totally 3.87 with higher value in KF (5.06) and lower in PF (4.5) immediately after finishing surgery and getting conscious when started using infusion pump. There was no statistical difference between the groups in this regard. Concerning the side effects of the applied medications, blood pressure and heart rate had no differences comparing the groups.Conclusion: This study showed that paracetamol used in infusion pump can be brilliant in pain control after major surgeries like what done in lower extremities and joint replacement while lessens opioid use. Although paracetamol was more effective than ketamine in the current trial, more qualified studies at bigger size and in other fields of surgery beside orthopedic ones would be useful to support the effects if applicable.Keywords: Infusion pump, Ketamine, Paracetamol, Fentanyl, Postoperative pai

Evaluation of the effect of favipiravir on patients with COVID-19

Background: The novel coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) started in December 2019 in Wuhan, China. No specific drug has been accepted for COVID-19 treatment up to now. Favipiravir as an antiviral drug affects RNA viruses like influenza and Ebola. Accordingly, the aim of this study is the evaluation of favipiravir's effect on COVID-19 outcomes. Method: This is a randomized controlled study including 97 patients with COVID-19 randomly allocated into favipiravir or control groups. The primary outcomes were improvement of clinical manifestations and atrial oxygen saturation (SpO2), and the secondary outcome was the length of hospitalization. Results: Clinical manifestations recovery of COVID-19 patients was better in the favipiravir group, and the mortality rates were less than in the control group (P = 0.0001 for both). The level of blood oxygen saturation (SpO2) was significantly higher in the favipiravir group (P = 0.0001). The mean lymphocyte count was lower in the control group (P = 0.004). In addition, levels of blood urine nitrogen (BUN) were higher in the favipiravir group (P = 0.033). The length of hospitalization was similar in both groups (P = 0.586). Conclusion: Favipiravir can be effective for clinical and laboratory improvement of COVID-19 patients, and it is a promising drug for decreasing of mortality rate in these patients