الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Caesarian section is the most commonly performed surgery in gynecology and obstetrics in the world, which is a steadily increasing trend. Unsuccessfully conducted analgesia after caesarian section results in considerable suffering in newly delivered mothers, who consequently may be less willing to feed and care for the new-born. To achieve effective analgesia, a multimodal strategy should be used with simultaneously administered painkillers.
The aim of this study was evaluate the effectiveness of intravenous ibuprofen versus intravenous ketorolac for postoperative pain relief after caesarian section. The Primary aim was measurement of visual analogue score during rest and movement and the secondary aim was measurement of 24 hours opioid requirements.
After approval of local Ethics Committee of Alexandria faculty of medicine and obtaining a written informed consent from all parturients, the present study was carried out in El-Shatby University Hospital on 50 parturients scheduled for elective caeserian section according to the sample size calculation, in a double blinded study. Parturients were randomly assigned to one of two equal groups (25 in each group). All of them were informed with the anaesthetic techniques and trained to use the visual analogue scale (VAS).
On arrival to the operative theatre a peripheral venous catheter was inserted in all parturients,a multichannel monitor was attached to display ECG (lead II), heart rate (beats/min), non-invasive mean arterial blood pressure (mmHg) and oxygen saturation (SpO2).
General anaesthesia was performed using propofol, fentanyl and roccuronium.
All parturients were discharged to ward to be put under observation for 24 hours and they were given NSAID immediately on arrival to the ward.
Postoperative pain assessment using VAS was recorded at 2h, 4h, 6h, 12 h and 24 h postoperatively and total amount of IV pethidine was recorded at the end of the 24 postoperative hours as well as the time of the first dose required by the parturient. Parturient satisfaction with pain management was evaluated by the anaesthetist before parturients were discharged home.
The results were as follows:
Regarding the demographic data, comparing the two studied groups, there were no significant differences between the two studied groups.
Comparison of the two studied groups revealed a significant increase in HR and MABP in group A compared to group B at 2, 4, 6, 12, 24 hours after administration of drugs.
Comparison of the two studied groups revealed a significant increase in VAS (r),VAS (m) and opioid requirement in group A compared to group B .
The comparison between both groups in time to first analgesic requirement showed a significant increase in group B compared to group A.