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INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH

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IJPR included in UGC-Approved List of Journals - Ref. No. is SL. No. 4812 & J. No. 63703

Published by : Advanced Scientific Research
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0975-2366
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IJPR 9[3] July - September 2017 Special Issue

July - September 9[3] 2017

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Comparison of Epidural Block and Apotel in Controlling Pain among Patients with Rib Fracture

Author: SAEID HEIDARI, ALIREZA KAMALI, SIAMAK RAKEI ESFEHANI, MAHMOUD AMINI
Abstract: Rib fracture is one of the most common traumatic fractures. Chest injuries are the cause of traumatic hospitalization in 8-15% of patients. Basis of fracture therapy includes pain control, chest physiotherapy and respiratory care. Pain control can be done in a variety of ways such as intravenous analgesia, and the use of local anesthetics (e.g., topical gel and nerve blocks). Among the nerve blocks, the most commonly used method is the thoracic epidural block. Venous acetaminophen (apotel) is one of the most commonly applied drugs to control the pain of patients. we compared the two methods of treating the thoracic epidural analgesia and apotel in pain management. This double-blind clinical trial was performed on all patients referred to Vali-e-Asr Hospital, Arak-Iran, with rib fracture. One group received Marcaine 0.25 at 0.3 cc/kg and the other group received one gram of apotel in 200 ml normal saline. Heart rate and mean blood pressure and pain were recorded in 15 minutes, 1, 2, 4, 12 and 24 hours after the procedure. Data were then analyzed by SPSS software. A total of 84 patients entered the study. The mean age was 53.4 ± 3.6 years in the thoracic epidural group and 51.9 ± 4.5 years in the apotel group. In the thoracic epidural group, 66.6% were male and 33.4% female respectively. In apotel group, 64.8% were male and 35.2% were females. No significant difference was observed in the mean pain of patients before intervention (P =0.05), but there was a significant difference between 15 minutes, 1, 4 and 12 hours after intervention (P =0.05), Therefore, the pain score in the epidural group was less than the apotel. In addition, the mean blood pressure in the epidural group was lower than the apotel at 15 minutes after the intervention (P = 0.01). Furthermore, the mean heart rate in the epidural group was lower than the apotel at 15 minutes and immediately after intervention (P = 0.02). The mean duration of anesthesia was found to be higher in the epidural group as compared to the apothecary group (P = 0.01), and the length of hospital stay in the apotel was more than the thoracic epidural group. Based on the findings presented herein, the pain was less in the epidural group at all times than the apotel, and the duration of analgesia was higher in the thoracic epidural group and the duration of hospitalization was lower, it is concluded the epidural thoracic method can be used effectively for reducing the pain in patients with fracture of the rib
Keyword: Thoracic epidural analgesia, apotel, Rib fracture.
DOI: https://doi.org/10.31838/ijpr/2019.11.02.054
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