Postoperative pain relief following abdominal operations: A prospective randomised study of comparison of patient controlled analgesia with conventional parenteral opioids

BACKGROUND: Parenteral opioids are traditionally used for pain management following abdominal operations. Patient Controlled Analgesia (PCA) is replacing the conventional method for postoperative pain relief nowadays. AIMS: To find out the effectiveness of PCA in postoperative pain relief following abdominal operations. SETTINGS AND DESIGN: This prospective randomised study was conducted in the Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India. MATERIALS AND METHODS: Sixty-two consecutive patients undergoing abdominal operations were randomly divided into PCA group (n=32) who received intravenous PCA morphine and IM group (n=30) who received conventional intramuscular morphine in the postoperative period. Morphine consumption, pain relief, detailed pulmonary function tests and side-effects of morphine were assessed. STATISTICAL ANALYSIS: This was performed by "Epi Info 2000 version 6". Chi-square and Students 't' tests were used to relate the variables. RESULTS: The total morphine consumption of the PCA group was significantly lesser than IM group (mean 30.84 mg versus 37.36 mg P-0.015) and it was less at different intervals in the postoperative period. The PCA group had better pain relief when compared to the IM group (mean pain score 3.42 versus 4.97 P<0.001). Pulmonary function parameters did not show a significant difference at different intervals in the postoperative period except for Peak Expiratory Flow Rate. None of the patients had major morphine-related complications. CONCLUSIONS: Intravenous PCA provides better pain relief with less morphine consumption as compared to the conventional IM method. Recovery of postoperative pulmonary functions showed no significant difference in the two groups apart from Peak Expiratory Flow Rate, which showed significant early recovery in the PCA group

A European lens upon adult and lifelong learning in Asia

In this article, we seek to assess the extent to which adult and lifelong learning policies and practices in Asia have distinctiveness by comparison to those found in western societies, through an analysis of inter-governmental, national and regional policies in the field. We also inform our study through the analysis of the work of organisations with an international remit with a specific focus on Asia and Europe. In one case, the Asia–Europe Meeting Lifelong Learning (ASEM LLL) Hub has a specific function of bringing together researchers in Asia and Europe. In another, the PASCAL Observatory has had a particular focus on one aspect of lifelong learning, that of learning cities, with a concentration in its work on Asia and Europe. We focus on learning city development as a particular case of distinction in the field. We seek to identify the extent to which developments in the field in Asia have influenced and have been influenced by practices elsewhere in world, especially in Europe, and undertake our analysis using theories of societal learning/the learning society, learning communities and life-deep learning. We complement our analysis through assessment of material contained in three dominant journals in the field, the International Journal of Lifelong Education, the International Review of Education and Adult Education Quarterly, each edited in the west

De Novo and Rare Inherited Copy-Number Variations in the Hemiplegic Form of Cerebral Palsy

PurposeHemiplegia is a subtype of cerebral palsy (CP) in which one side of the body is affected. Our earlier study of unselected children with CP demonstrated de novo and clinically relevant rare inherited genomic copy-number variations (CNVs) in 9.6% of participants. Here, we examined the prevalence and types of CNVs specifically in hemiplegic CP.MethodsWe genotyped 97 unrelated probands with hemiplegic CP and their parents. We compared their CNVs to those of 10,851 population controls, in order to identify rare CNVs

Postoperative pain relief following abdominal operations: A prospective randomised study of comparison of patient controlled analgesia with conventional parenteral opioids

BACKGROUND: Parenteral opioids are traditionally used for pain management following abdominal operations. Patient Controlled Analgesia (PCA) is replacing the conventional method for postoperative pain relief nowadays. AIMS: To find out the effectiveness of PCA in postoperative pain relief following abdominal operations. SETTINGS AND DESIGN: This prospective randomised study was conducted in the Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, India. MATERIALS AND METHODS: Sixty-two consecutive patients undergoing abdominal operations were randomly divided into PCA group (n=32) who received intravenous PCA morphine and IM group (n=30) who received conventional intramuscular morphine in the postoperative period. Morphine consumption, pain relief, detailed pulmonary function tests and side-effects of morphine were assessed. STATISTICAL ANALYSIS: This was performed by "Epi Info 2000 version 6". Chi-square and Students 't' tests were used to relate the variables. RESULTS: The total morphine consumption of the PCA group was significantly lesser than IM group (mean 30.84 mg versus 37.36 mg P-0.015) and it was less at different intervals in the postoperative period. The PCA group had better pain relief when compared to the IM group (mean pain score 3.42 versus 4.97 P<0.001). Pulmonary function parameters did not show a significant difference at different intervals in the postoperative period except for Peak Expiratory Flow Rate. None of the patients had major morphine-related complications. CONCLUSIONS: Intravenous PCA provides better pain relief with less morphine consumption as compared to the conventional IM method. Recovery of postoperative pulmonary functions showed no significant difference in the two groups apart from Peak Expiratory Flow Rate, which showed significant early recovery in the PCA group

Comparison of clinical tests and doppler ultrasound in the preoperative assessment of lower extremity varicose veins

Introduction: Varicose vein of the lower extremity is a very common problem and is associated with severe morbidity if left untreated. Recurrence is inevitable if preoperative assessment of incompetence is not accurate. This study aims to compare the accuracy of clinical tests and Doppler ultrasound in the localization of incompetence with the Turner Warwicks bleed back sign at operation. Materials and Methods: This is a prospective study of patients with lower limb varicose veins admitted to the department of general surgery. 53 limbs were studied in 50 patients. They were evaluated by clinical tests and Doppler ultrasound. Results: Saphenofemoral incompetence was correctly diagnosed in all 53 limbs both by clinical test and Doppler ultrasound. In the evaluation of perforator competency, the sensitivity was 82.93% by clinical tests and 97.56% by Doppler ultrasound. Conclusion: Doppler ultrasound evaluation of the varicose veins should be done for accurate diagnosis in all patients before planning surgery