Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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This study aimed to assess 1) agreement and correlation of postoperative pain scores rated by nurses and parents 2) the difference between the pain scores (CHEOPS and FLACC) as rated by nurses and parents 3) effects of parental education on pain rating 4) the ease with which parents could score CHEOPS and FLACC. ⋯ Thai parents could be easily trained how to use pain scales. Parental rating was not different from nurse rating. The agreement and correlation between parents and nurses were very high. The ease of using CHEOPS was not different from FLACC.
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Case Reports
Kikuchi-Fujimoto's disease, histiocytic necrotizing lymphadenitis, mimicking systemic lupus erythematosus.
Kikuchi-Fujimoto's disease (KFD) or histiocytic necrotizing lymphadenitis is a self-limiting condition characterized by fever, neutropenia and lymphadenopathy. It is rarely associated with systemic lupus erythematosus (SLE). ⋯ The clinical symptoms resolved spontaneously within 3 months without any treatment. Because there is an association between KFD and SLE, great care should be taken with a patient who presents with either KFD or SLE.
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Transillumination of the soft tissue of the neck using a lighted stylet (lightwand) is an effective and safe intubating technique in experienced hands. The goal of this study was to determine the effectiveness and safety of this device in intubating the trachea of elective surgical patients by non-experienced hands. One hundred and fifty, paralysed, anesthetized, adult patients (ASA I-II, no known or potential problems with intubation) were studied. ⋯ There were significantly fewer traumatic events (5.33%). Most of the trauma consisted of minor mucosal bleeding or mucosal laceration. We conclude that lightwand intubation is an effective and safe technique in non-experienced hands.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A double-blind, randomized study comparing postoperative pain management using epidural ropivacaine with intravenous ketorolac or intravenous ketorolac alone following transabdominal hysterectomy.
The aim of this study is to compare the effect on postoperative pain of epidural ropivacaine in combination with intravenous ketorolac with intravenous ketorolac alone following transabdominal hysterectomy. ⋯ We demonstrated that epidural infusion of ropivacaine in addition with intravenous ketorolac gave superior pain relief at rest and on coughing in patients undergoing transabdominal hysterectomy when compared to the group receiving intravenous ketorolac alone.
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Randomized Controlled Trial Clinical Trial
Starting intravenous morphine in the postanesthesia care unit yielded better postoperative analgesia.
The administration of morphine intravenously in the Postanesthesia Care Unit (PACU) was practiced in many parts of the world, but not routinely done in Thailand. This prospective randomized controlled trial was performed to reassure Thai personnel that this practice was safe, to find the optimum dose of morphine for administration in the PACU, and to find the pain level at which patients needed no more analgesics. Eighty gynecological patients, ASA class I or II, were randomly allocated into two groups. ⋯ We concluded that giving morphine intravenously in the PACU was safe, effective and reduced postoperative analgesic requirement. The dose of morphine in the PACU could be calculated from the pain score at patients' first request for analgesics. Most patients declined additional analgesics when their pain was acceptable and tolerable.