Perioperative parecoxib compared with postoperative parecoxib improves post-discectomy pain and results in a reduction in adverse effects associated with opioid therapy. Postoperative parecoxib, or a single pre-incisional parecoxib dose, does not significantly improve post-discectomy pain or opioid side-effects up to 3 days after surgery.

OBJECTIVE: To evaluate the performance of continuously working blood culture systems in a discontinuous laboratory system. METHODS: The systems used were BacT/Alert (Organon Teknika Corp., Durham, NC) and BACTEC NR 860 (Becton Dickinson Diagnostic Instruments, Sparks, Md) in a comparison in a laboratory staffed 8 1/2 h on Mondays to Fridays and 4 1/2 h on Saturdays. Blood culture bottles (BacT/Alert aerobic and anaerobic, BACTEC NR 26 A and NR 27 A) were received thrice daily. RESULTS: From 1824 pairs of blood culture vials, 110 clinically significant microorganisms were recovered by both BACTEC and BacT/Alert, 43 by BACTEC alone, and 33 by BacT/Alert alone. The differences between the systems in total recovery and in recovery of individual species were not statistically significant. The average detection times were 13.36 h for BACTEC and 13.93 h for BacT/Alert (P>0.1). These times represent only 35.6% (BACTEC) and 32.6% (BacT/Alert) of the total timespans from collection of blood to informing the ward of a positive result (tcrd, clinically relevant detection time). If 24 h per day blood culture processing conditions and continuous transport of vials to the laboratory had been available, these percentages would have risen to 87% (BACTEC) and 87.5% (BacT/Alert). Under such 'ideal' conditions, ttrd could have been reduced by 22.16 h using BACTEC and by 26.81 h using BacT/Alert. The BacT/Alert system showed more false-positive results than the BACTEC system (80 (4.39%) versus 23 (1.26%), P<0.001). CONCLUSIONS: No time benefit for detection of positive blood cultures is gained with continuously measuring systems, if loading and processing of vials is organized discontinuously, as in our laboratory.

Perioperative administration of the cyclooxygenase 2 inhibitor rofecoxib decreases pain scores and morphine consumption after orthopaedic, breast and spine surgery. However, the benefit of preoperative administration of the cyclooxygenase 2 inhibitor seems to be only moderate, suggesting that early postoperative administration may be a useful alternative approach. There is no evidence that the type of surgery influences analgesic effects of cyclooxygenase 2 inhibitors.