Ultrasound-guided TAP block holds considerable promise as a part of a balanced postoperative analgesic regimen for patients undergoing open appendicectomy.

We studied 36 patients, allocated randomly to receive meloxicam 15 mg rectally (n = 18) or placebo suppository (n = 18) before total abdominal hysterectomy in a double-blind study. Visual analogue scores for pain at rest (P < 0.005), on movement (P < 0.05) and on coughing (P < 0.05) were significantly decreased in the meloxicam group during the first 24 h after surgery. Mean 24-h PCA morphine requirements were 33.2 (SD 16.9) mg and 38.2 (20.8) mg in the meloxicam and placebo groups, respectively (ns). There was no difference in the incidence of nausea, vomiting or sedation between groups.

SummaryThere is little evidence that local anaesthetics produce pre-emptive analgesia and one reason may be the short duration of action of the drugs studied. We examined the pre-emptive analgesic effect of a bupivacaine field block on postoperative pain in 40 patients following herniorrhaphy in a doubleblind, randomised trial. Patients received the block either after induction but before surgery, or after surgery but before the end of anaesthesia. There was no difference in pain scores or analgesic consumption up to 7 days after surgery between the two groups. We have demonstrated that bupivacaine does not appear to provide significant pre-emptive analgesia following a field block for herniorrhaphy. This study does not support the hypothesis that pre-emptive analgesia with local anaesthetic depends upon the duration of action of the drug.

No abstract

Background: Knee osteoarthritis is a common disease of old age which causes difficulty in activities of daily living. The hamstring muscle tightness is often associated with grade 1 and 2 knee osteoarthritis. The treatment of knee osteoarthritis includes stretches, strengthening and mobilization of joints, these may also improve the hamstring muscle length. Objectives: To determine effects of knee Joint Mobilization on hamstring muscle length in Patient with Knee Osteoarthritis. Methodology: A randomized clinical trial study was conducted at Benazir Bhutto Hospital Rawalpindi from September 2020 to December 2020. A total of n=44 participants were included male and female of age between 40-65 years after screening for pain more than 3 on Numeric Pain Rating Scale (NPRS) for more than 3 months, 20% hamstring length shortening in degree, grade I &II osteoarthritis according to Kellgren and Lawrence Classification system also satisfying American College of Rheumatology for clinical classification of Knee OA. The Hamstring screening was done using Active knee extension test (AKET), 90-90 test and sit and reach test. They were randomly allocated in group A received post isometric relaxation (PIR) and group B Kaltenborn mobilization and traction (KM+KT) group. Each participant received three sessions per week for 4 weeks. The data was collected at baseline, post 1st session and after 12th session by using Numeric pain rating scale (NPRS) for pain, Active knee extension test (AKET) for hamstring flexibility and WOMAC scale for functional disability. Data analysis was done through SPSS-21. Result: The mean age of the study participants was 48.15±9.70 years. Both groups have shown statistically and clinically (p<0.001) improvement regarding pain, muscle length and functional disability after treatment duration till 12th session. When comparing the groups KM+KT group showed more significant improvement with large effect size (p<0.05) regarding pain, hamstring muscle length and functional disability as compared to PIR group at the end of 12th session. Conclusion: Kaltenborn mobilization and traction group has shown significant improvement in pain, muscle length and functional status as compared to the PIR group. Keywords: Active knee extension test, Hamstring flexibility, Kaltenborn mobilization, Muscle length, Osteoarthritis.