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Background&Objective: Pain, in particular post-operative pains, can produce numerous complications including a delay in healing of wounds in patients. For pain relief in patients postoperatively, different drugs are used, opioids like pethidine and NSAIDs. This study was carried out to compare the effects of the IM pethidine and suppository Diclofenac for pain relief after laminectomy following lumbar disc hernia.
Materials&Methods: this is a randomized control clinical trial study, 100 patients presenting for laminectomy with diagnosis of lumbar disc hernia and eligible for participation in the study, after recieving their informed consent for inclusion in the study non probability convenience sampling were selected by a convenience sampling method and then divided into two groups of Pethidine (P) and Diclofenac (D). Patients’ pain scores were measured by Visual Analogue Scale (VAS). Finally, the data obtained were analyzed by statistical software of SPSS.10, F test, T test and ?² P<0.05 was considered significant.
Results: Mean pain scores within 24 hours after operation were calculated in group P as 2.8±2.02 and in group D as 4.46±2.30. There was a statistically significant difference between the reduction of the pain score after surgery in both groups (p<0.05). Nausea was the greatest side effect observed in group P (23%) and epigastric pain was the most common pain found in group D (18%). However, no statistically significant difference was found between the two groups in terms of the drug adverse effects.
Conclusion: A statistically significant difference was observed between pethidine ampule and Diclofenac suppository regarding the pain reduction after laminectomy. In the other words, Diclofenac suppository has less impact on pain killing in comparision with Pethidine ampule. In other to confirm these results, it is suggested that another study in terms of age and sex and after orthopedical procedures in a large scale-and if possible double blind- to be carried out.

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Background & Objective: Nutritional support is a basic process for survival in trauma patients. The purpose of this study was to evaluate the daily nutritional support practice in head injury patients admitted to Neurosurgery Intensive Care Unit.

 

Materials & Methods: This descriptive cross-sectional study was done on 115 Head injury adults patients who received enteral nutrition for at least 48h in Rasht Poursina hospital during 2005. Nutritional measurements were included the number of patients who received enteral nutrition, the time to initiate nutritional support, amount of initial feeding and clinical outcome were included the duration of mechanical ventilation, ICU and in-hospital length of stay (loss), in-hospital mortality rates .Data was reported as Mean±SD and percent. T-test analysis was used for comparing of calorie and nutrient intakes and requirements.

 

Results: Mean±SD of age patient was 41.22±21.9, 84% of patients received enteral nutrition. The time to feeding and the amount of initial feeding was 4.6±1 day and 52.79±27.83 ml/h respectively. Duration of ventilation was 12±13.4 day and ICU length of stay 18.96±18.3 day, Hospital length of stays 24.47±19.84 day. Mortality rate in six month was 48%. Mean of energy, carbohydrate, fat and protein (P<0.05) intakes had significant differences compared with requirements.

 

Conclusion: The recording process has revealed undesirable feeding practice in head injury patients. Nutritional outcomes would be improved with implementation of standard protocol in neurosurgery intensive care unit.