Current treatments for post-injury movement-evoked pain are inadequate. Non-opioids may complement opioids, which preferentially reduce spontaneous pain, but most have incomplete efficacy as single agents. This trial evaluates efficacy of a gabapentin-rofecoxib combination following hysterectomy. In addition to IV-PCA morphine, 110 patients received either placebo, gabapentin (1800 mg/day), rofecoxib (50 mg/day) or a gabapentin-rofecoxib combination (1800/50 mg/day) starting 1 h pre-operatively for 72 h. Outcomes included pain at rest, evoked by sitting, peak expiration and cough, morphine consumption and peak expiratory flow (PEF). For placebo, gabapentin, rofecoxib and combination, 24 h pain (100 mm VAS) was: at rest-23.6 (P<0.05 vs. all treatments), 13.8, 14.4 and 12.1; during cough-50.7 (P<0.05 vs. all treatments), 41.5, 44.8 and 30.8; 48 h morphine consumption (mg) was: 130.4 (P<0.05 vs. all treatments), 81.7, 75.6 and 57.2 (P<0.05 vs. gabapentin and rofecoxib) and 48 h PEF (% baseline) was: 63.9 (P<0.05 vs. all treatments), 77.2, 76.7 and 87.5 (P<0.05 vs. gabapentin and rofecoxib). Adverse effects were similar in all groups except sedation which was more frequent with gabapentin. Combination and rofecoxib reduced pain interference with movement, mood and sleep (P<0.05) and combination was superior to gabapentin for all these three (P<0.05). These data suggest that a gabapentin-rofecoxib combination is superior to either single agent for postoperative pain. Other benefits include opioid sparing, reduced interference with movement, mood and sleep and increased PEF suggesting accelerated pulmonary recovery. Future research should identify optimal dose-ratios for this and other analgesic combinations.

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Juvenile, 1‐g Colossoma macropomum (Cuvier) were fed two different diets: one with fish meal and another with soya meal as the main dietary protein source. Both diets were provided at ad libitum feeding level, and at two restricted feeding levels of ∼ 80% and 60% of the ad libitum level. The experiment was performed in 30 aquaria, each stocked with 12 fish. For each treatment (two diets X three feeding levels), there were five replicates. Fish were fed three times daily at 0900, 1300 and 1700 h. At sampling days (days 14, 29, 44) in each aquarium in one of these feedings, chromic‐oxide‐marked feed was used. Shortly after the last meal, fish were weighed and four fish were taken from each aquarium for determination of the chromic oxide content in their digestive tract. Fish fed the fish meal diet attained a higher weight but had a lower body protein content. At the ad libitum feeding level, feed intake of the fish meal diet was higher, but feed and protein utilization efficiency were lower than with the soya diet. However, statistical analysis of the data of both the ad libitum and the two restricted feeding levels revealed that the reduced voluntary feed intake of the soya diet was the cause of its better utilization with ad libitum feeding. There is no evidence that soya protein is more freely available than fish meal protein. The chromic oxide data showed that 15 min after feeding, all of the feed (99.8%) could be traced back in fish fed the lowest feeding level, while at the ad libitum feeding level the recovery was only 72%. These data confirmed the hypothesis that at high feeding levels, considerable amounts of feed remain uneaten. Feed losses were not significantly different between the two diets. The chromic oxide recovery data of the 0900 h and 1300 h feedings showed that the feed passage rate in the digestive tract was similar for the three different feeding levels. Due to the high feed losses at high feeding levels, the relation between feed ration and feed utilization is determined mainly by the percentage of feed losses at the different feed rations.