Background: Post-operative pain is a protective but an unwanted effect which is to be treated for the better outcome of surgery. Aims and Objectives: The aim of this study is to compare the safety and analgesic efficacy of intravenous patient-controlled analgesia (IV PCA) using morphine and fentanyl for post-operative pain management in major surgery patients. Materials and Methods: The randomized clinical study initiated after the ethics committee approval and informed consenting. A total of 60 patients belonging to the American Society of Anesthesiology Grade -I, II, and III physical status, scheduled for major abdominal, oncological surgeries under general anesthesia were randomly allocated to two groups. Group M received IV PCA with morphine (basal continuous infusion 0.02 mg/kg/h, bolus dose of 0.02 mg/kg, and lockout period of 20 min), and the Group F received IV PCA with fentanyl (basal continuous infusion 0.5 µg/kg/h, bolus dose of 0.5 µg/kg, and lockout period of 20 min). Fentanyl dosage was converted into morphine equivalents. The outcomes such as visual analog scale (VAS), sedation score, hemodynamic parameters, and adverse effects were compared between groups and analyzed statistically. Results: Morphine provides better analgesia than fentanyl as indicated by lower VAS scores (score = 3) at the end of 24-72 h. Mean cumulative analgesic consumption was higher in fentanyl group (436.3 ± 330.2 mg) compared with morphine group (123.9 ± 28.2 mg) by 72 h. Regarding the hourly consumption, Group M consumed less drug than fentanyl group was statistically significant (P = 0.05). Conclusion: Morphine provides more effective post-operative analgesia than fentanyl administered through IV PCA. The PCA allows patients to balance between administration of analgesics and adverse events by self-adjusting the dose of analgesic used.
Background:The newly established drug and poison information center (DPIC) at the Department of Pharmacology, Akash Institute of Medical Sciences and Research Centre, located at Devanahalli, Bangalore Rural, Karnataka, India, provides drug and poison information services to healthcare professionals (HCP) and to the patients. The DPIC is effectively functioning since 2016. Aims and Objectives: To assess and evaluate the services delivered by DPIC. Materials and Methods: A cross-sectional observational study was conducted over 1-year period (December 2016-November 2017) to assess the patterns of queries received by DPIC. A total of 147 drug and poison-related information queries were received and answered during the study period. Data analysis was done by GraphPad. Results: Of the total queries received, majority of queries were from HCP (49%) followed by doctors (42%) and patients (9%). Majority of the queries (82.2%) were received by telephone access/WhatsApp messages (60%). A total of 60.54% queries were related to know the identity, symptoms, antidote, and management of poisoning cases. Most of the queries were for better patient care (88%) and the information was provided verbally for majority of the queries (81%). For most of the poisoning queries (62.9%), the information was provided immediately significantly (P < 0.05). Conclusions: DPICs can offer drug consultation services for HCP and patients in identifying poisons, symptoms, antidotes and management of poisoning cases and well detect and prevent adverse drug reactions and drug-drug interactions, etc. Therefore, improve overall patients' healthcare standards can promote rational therapeutics.
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