DefinePK

Research Objective

To compare the frequency of opioid requirement after intravenous lignocaine infusion and ketorolac tromethamine in patients undergoing upper limb surgeries.

Methodology

Quasi-experimental study involving ASA I/II patients of either gender undergoing upper limb surgery. Patients were randomly divided into two groups: L (Lignocaine) and K (Ketorolac). The L-group received an intravenous lignocaine bolus followed by an infusion during the procedure. The K-group received intravenous ketorolac at induction. Patients were monitored for 12 hours postoperatively, and rescue analgesia (intravenous Nalbuphine) was provided if the Visual Analogue Scale (VAS) score was >5. Data analysis was performed using SPSS version 23, with Chi-square test applied for comparisons.

Methodology Flowchart

                        graph TD;
    A["Patient Selection ASA I/II, Upper Limb Surgery"] --> B["Random Assignment"];
    B --> C["Group L: Lignocaine Infusion"];
    B --> D["Group K: Ketorolac"];
    C --> E["Intraoperative Monitoring & Administration"];
    D --> E;
    E --> F["Postoperative Monitoring 12 hours"];
    F --> G["VAS Score > 5?"];
    G -- Yes --> H["Rescue Analgesia Nalbuphine"];
    G -- No --> I["Record Opioid Requirement"];
    H --> I;
    I --> J["Data Analysis SPSS"];
    J --> K["Conclusion"];                    

Discussion

The study suggests that intraoperative intravenous lignocaine infusion is superior to ketorolac in managing postoperative pain in upper limb surgeries, leading to reduced opioid requirements. This aligns with some previous studies but contrasts with others, highlighting the need for further research. The safety of the lignocaine dosage used was confirmed by the absence of notable complications.

Key Findings

Eighty patients were included. There was no statistical difference between the groups in age, gender, or ASA status. A statistically significant difference was observed in opioid requirement at 1-hour (p=0.035), 6-hours (p=0.032), and 12-hours (p=0.035), with the K-group showing a higher requirement compared to the L-group.

Conclusion

Intraoperative administration of intravenous lignocaine infusion (after an initial bolus dose) is superior to ketorolac in effective postoperative pain management in patients undergoing upper limb surgeries.

Fact Check

* Total eighty patients were included in the study. (Confirmed)
* Opioid requirement at 1-hour showed a p-value of 0.035. (Confirmed)
* The study was conducted from Oct 2017 to Apr 2018. (Confirmed)

Mind Map