INTRODUCTION The management of pain in polytrauma patients is mandatory. While non-steroidal anti-inflammatory drugs (NSAIDs) represent the most used drugs in polytrauma patients, their use may be associated with an increased risk of haemorrhage. Opioids may represent a valid alternative to NSAIDs either alone or in combination with acetaminophen. Whether their efficacy is comparable to that pr...

Evidence • Adults—2 RCTs (N = 140) of predominantly middle-aged women with Colles fractures randomized to flurbiprofen (14 days)1 or piroxicam (20 mg/d for 8 weeks)2 versus placebo: -No difference in recovery time, physiotherapy needs, malunion or nonunion,1 functional recovery, or healing.2 -Superior pain relief with NSAIDs (both trial arms allowed acetaminophen if required). -Limitations: abo...

Oral ketorolac tromethamine (KT) in 10 and 20mg postoperative doses in an oral surgery pain model have proven to be equally analgesic as 400mg ibuprofen, and significantly better than acetaminophen and acetaminophen-codeine combinations. It prevents pain by blocking arachidonic-acid pathway. To evaluate the analgesic effect of preoperative KT-10mg, on pain during and after open flap debridement...

OBJECTIVES To determine whether the occurrence of paracetamol and non-paracetamol analgesic deliberate self-poisoning (DSP) and accidental paediatric poisoning was affected by two periods of recall of paracetamol products. DESIGN Retrospective, observational audit of proportions of poisonings with tablet and capsule formulations of paracetamol, ibuprofen and aspirin products during two recall...

Analgesic headache occurs when drugs given for the treatment of headache aggravate symptoms. The condition is well recognised in adults but has not been described before in children in whom it may be induced by mild analgesics such as paracetamol used alone. Twelve children (nine girls and three boys, aged 6 to 16.5 years) with analgesic headache (from three months to 10 years) are reported. Fi...

PURPOSE To assess and compare the onset time and duration of neuroblockade obtained after ropivacaine or bupivacaine in infants undergoing major abdominal surgery. We also evaluated the efficacy and safety of employing ropivacaine instead of bupivacaine to provide operative anesthesia and postoperative analgesia. METHODS In a prospective double blind study 28 infants, aged 1-12 months, underg...

BACKGROUND We examined forensic serum toxicology and pharmacogenomics data from a woman on codeine shortly before she caused a motor vehicle accident. METHODS A woman driving erratically collided with a parked car of a highway seriously injuring 2 men working to repair the parked vehicle. The woman tested positive for codeine, acetaminophen and barbital. She had been taking these medications ...

CONTEXT Dexamethasone is widely used to prevent postoperative nausea and vomiting (PONV) in pediatric tonsillectomy. OBJECTIVE To assess whether dexamethasone dose-dependently reduces the risk of PONV at 24 hours after tonsillectomy. DESIGN, SETTING, AND PATIENTS Randomized placebo-controlled trial conducted among 215 children undergoing elective tonsillectomy at a major public teaching hos...