Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Descriptive study of an 8-year period, 211 patients with hepatic trauma were studied retrospectively. Most of the patients were male (81.5%). Patients mainly affected were in the third decade of life (46.9%) with an age range of 2 to 65 years old (Mean 26.1 +/- 9.8). ⋯ Exsanguination and associated head injuries were the major cause of death (83%). Nonsurvivors had a significantly higher shock, blunt injury, associated injury and high grade hepatic injury than survivors (p < 0.005). The high mortality and morbidity can be achieved by well regulated motorcycle accident prevention measures and well prehospital care.
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Randomized Controlled Trial Clinical Trial
Single dose oral clonidine premedication does not enhance postoperative, single low dose epidural morphine analgesia in hysterectomy patients.
In this randomized, double blind placebo controlled study, the authors evaluated the effects of oral clonidine premedication on very low dose epidural morphine analgesia in 50 hysterectomy patients. Patients were randomized to receive a single oral clonidine 300 microg (n = 25) or a placebo (n = 25) 90 minutes before insertion of the epidural catheter. 3 ml of 2% lidocaine with adrenaline (5 microg ml(-1) mixed with 2 mg morphine were injected via epidural, followed by an additional volume of 2% lidocaine with adrenaline (5 microg ml(-1)) titrated to T6 block height before commencing general anesthesia. The postoperative analgesia regimen was 2 mg of intravenous morphine every 10 minutes for the first 48 hr and 1 gm of oral acetaminophen every 4-6 hr after initiation of oral diet at 24-48 hr as required. ⋯ Pain scores at rest and movement were also not different in both groups (p = 0.83, p = 0.64) respectively. No serious adverse effects were noted. The authors concluded that oral clonidine approximately 6 microg kg(-1) does not enhance the analgesic effect of epidural morphine 2 mg after hysterectomy.
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Randomized Controlled Trial Clinical Trial
The efficiency of different adjunct techniques for regional anesthesia.
In the present prospective, randomized controlled trial, 110 unpremedicated patients undergoing orthopedic surgery under regional anesthesia were randomly divided into 5 groups, with 22 patients in each. During the operation, group 1 listened to a pre-recorded explanation and music, group 2 listened to a subliminal sound, group 3 received propofol by patient-controlled sedation (PCS), group 4 received intravenous midazolam, and group 5 was the control group. ⋯ The group that listened to an explanation and music were significantly less satisfied than the propofol group at the end of the operation and 30 min. postoperatively. An incremental cost-effectiveness ratio showed that if explanation and music are used instead of propofol it would save 299.53 baht per patient, but the patient satisfaction score will be 17.26 points lower than if the more expensive drug is used.
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Clinical Trial
Cross-validation of a self-report scale for postoperative pain in school-aged children.
The present study cross-validated self-report pain scales: Verbal Rating Scale (VRS), Facial Expression Scale (FACES), Color Analogue Scale (CAS) and Poker Chip Tool (PCT) in Thai children aged 5-12 years. The concordance with observational measure, Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) was also tested. Among 100 students, test-retest reliability of all self-report measures was moderate to good (K = 0.501-0.712) and only FACES yielded acceptable face validity(IC > 0.5). ⋯ Agreement of self-report measures and CHEOPS was better in the age group 5-8 years (K = 0.417-0.826) than 9-12 years (K = 0.231-0.529). In conclusion, FACES is a valid, reliable and practical tool. Self-report measures are more in concordance with CHEOPS in the younger age group.
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To determine the reliability of the Thai version of the Roland - Morris disability questionnaire in low back pain patients. ⋯ The Thai version of the Roland - Morris disability questionnaire is a reliable tool for assessing functional disability of low back pain in Thai patients.