Background:Reduction in central sensitization by gabapentinoids that include gabapentin and pregabalin may reduce acute postoperative pain.Aims:The aim of this study is to evaluate postoperative analgesic benefit and efficacy in patients administered with oral gabapentin or pregabalin as premedication for laparoscopic cholecystectomy under general anesthesia.Settings and Design:Randomized, prospective, and comparative study.Materials and Methods:In this study, recruited patients were randomly allocated in three groups. Groups A, B, and C received 2 capsules of B complex, 3 capsules of 300 mg gabapentin each, and 2 capsules of 75 mg pregabalin, respectively, each in 30 patients of each group, 1 h before induction of anesthesia. Postoperative efficacy among these three groups was compared with respect to increase in duration of analgesia, reduction in postoperative pain scores, total postoperative requirements of analgesics and side effects.Statistical Analysis:Mean and standard deviation were calculated. Test of analysis between two groups was done by t-test and among three groups by analysis of variance, and then P value was calculated.Results:Pregabalin and gabapentin group had lower visual analog scale (VAS) score (P < 0.05), prolonged timing of first rescue analgesic (4.67 ± 14.79 vs. 158 ± 13.10 vs. 343.16 ± 9.69) min, and less opioid consumption (169.87 ± 20.32 vs. 116.13 ± 14.08 vs. 64.67 ± 16.69) mg compared to placebo group. Between the gabapentinoids, pregabalin group had lower VAS score, prolonged timing of first rescue analgesic, and less opioids consumption than the gabapentin group.Conclusion:It is concluded in this study that pregabalin group had lower VAS score, prolonged timing of first rescue analgesic, and less opioids consumption than the gabapentin group. Both gabapentinoids had better postoperative analgesic profile than placebo.

Purpose: To report an unusual case of pulmonary edema following intramuscular ketamine administration. Clinical Features: An eight-year-old, healthy girl presented for dressing of first degree burns on dorsum of hand. Ten minutes after administration of 125 mg ketamine im, she developed laboured breathing, cyanosis, and bilateral crepitations and arterial blood gas analysis showed PaO 2 55 mmHg. There was no evidence of upper airway obstruction. On intubating the trachea, pink frothy fluid emerged from the tube. She was diagnosed as a case of neurogenic pulmonary edema. She was managed with positive pressure ventilation with positive end expiratory pressure, morphine and furosemide. With this treatment she showed a favourable recovery. Conclusion:Ketamine was given im to aid burns dressing in this case because it has distinct advantages above the other anesthetic agents including that of being a good analgesic which is absorbed by im route. Its use led to the development of pulmonary edema.Objectif : Signaler un cas inhabituel d'oedème pulmonaire survenu après l'administration intramusculaire de ké-tamine.Éléments cliniques : Une fillette de 8 ans, en bonne santé, s'est présentée pour un pansement sur des brûlures de premier degré au dos de la main. Dix minutes après l'administration de 125 mg de kétamine im, elle a présen-té une gêne respiratoire, de la cyanose et des crépitations bilatérales. La gazométrie artérielle a montré une PaO 2 de 55 mmHg. Il n'y avait pas d'évidence d'obstruction des voies aériennes supérieures. À l'intubation de la trachée, un liquide rosé spumeux sortait du tube. On a posé le diagnostic d'oedème pulmonaire neurogène. La ventilation à pression positive avec pression positive en fin d'expiration, de la morphine et du furosémide ont constitué le traitement. L'enfant a connu une bonne récupération.Conclusion : La kétamine im a été utilisée pour faciliter le pansement de brûlures à cause de ses avantages particuliers par rapport aux autres anesthésiques. En effet, elle fournit une bonne analgésie absorbée par voie im. Son emploi a provoqué l'apparition d'un oedème pulmonaire.

Many randomised controlled trials conducted worldwide favours for day-case laparoscopic cholecystectomy, but questions have been raised regarding its application in developing country like ours. Hence, considering it a high time to review current practices, we conducted this trial to report our experience with day-case laparoscopic cholecystectomy and to access its feasibility and safety in our set-up. Data from 65 patients with symptomatic gallstone were randomised to perform laparoscopic cholecystectomy either as day-case procedure or as routine (conventional) procedure. Complication, quality of life, satisfaction, post-operative nausea and vomiting and pain were assessed. Ninety-seven per cent (31/32) of day-case laparoscopic cholecystectomy patients were successfully discharged with mean duration of 8.9 ± 4.54 h, which was 3.33 ± 1.45 days (72.92 ± 34.8 h) in routine (conventional) laparoscopic cholecystectomy group. There was no significant difference in complication, quality of life, satisfaction, post-operative nausea and vomiting and pain between the two groups. Day-case laparoscopic cholecystectomy is a safe, feasible and beneficial procedure in our set-up. Patient acceptance in terms of quality of life and satisfaction was similar to that of routine laparoscopic cholecystectomy.

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