Effects of Preemptive and Preventive intravenous Paracetamol on postoperative pain and opioid consumption in patients undergoing laparoscopic nephrectomy

Background: Adequate pain control is a goal in post operative recovery. However opioids provide good analgesic effects, their side effects such as postoperative nausea and vomiting (PONV) limit their administration. Intravenous Paracetamol as a safe and well tolerated drug with lower side effects can be used instead of opioids for pain management.Objectives: The aim of this study is to compare preemptive or preventive administration of paracetamol with placebo group to investigate its effects on pain control and opioid consumption in patients undergoing laparoscopic nephrectomy.Patients and Methods: Ninety patients were randomly divided to three groups. Preemptive group received 1 gr paracetamol in 100 ml normal saline 30 minutes before induction of anesthesia, Preventive group received 1 gr paracetamol in 100 ml normal saline before closure of the skin and placebo group just received 100 ml normal saline. Post surgical pain was assessed using Verbal Rating Scale (VRS). Pethidine 0.25 mg/kg was administered and repeated each 10 minutes to control pain. Pain scores, total dose of opioid and symptoms like nausea and vomiting were recorded. Results: Preemptive and Preventive groups had lower pain scores than placebo group. Opioid consumption and PONV were significantly higher in placebo group. No significant differences were observed between Preemptive and Preventive groups.Conclusion: IV Paracetamol can provide an adequate pain control with low side effects and may be an effective choice in management of post operative pain in patients undergoing laparoscopic nephrectom

Quality of life of the mothers of children with autism

Background and Objective: Parents of children with autism have difficulty in their daily activities and social relationships and have a low quality of life. The negative effect of having a low intelligence or disabled child is more likely to cause tension and pressure on mother than the other family members. This study was conducted to determine the quality of life of mothers with autism children compared to mothers with normal children. Methods: This case-control study was performed on 36 mothers with autistic child and 114 mothers with healthy children in Gorgan (Iran) during 2015. Sampling was done randomly and the data gathering tool was SF-36 quality of life standard questionnaire. Results: The quality of life of mothers with autistic child had a significant reduction in comparison with the quality of life of mothers with healthy child (P<0.05). Also, items of quality of life including  general health, social function, and role limitation due to psychological, emotional and physical functioning in the group of mothers with autistic children were significantly lower than mothers with healthy ones (P<0.05). Conclusion: Mothers with autistic children had low quality of life. Therefore, it is recommended to design suitable programs for improving the health status and quality of life as a priority of health care plans