METHODS: This is a retrospective study of incidence and pattern of BT admitted to the Neurosurgery Department in HSNZ. Data was collected from the yearly census of BT registered from 2013 to 2018.
RESULTS: A total number of 386 new cases of primary BT were registered. The number of cases of BT was found to be lowest among children (0 to 10 years old) with only 4.4% but at peak among elderly aged between 51 to 60 years old (26.2%). As for gender, males constituted about 44.5% (n=172) whereas females accounted for 55.5% (n= 214) of the cases. In total, meningioma was found to have the highest incidence (27.2%) followed by metastases brain tumour (18.1%) and glioma (17.4%).
CONCLUSIONS: This study has shown that the incidence of BT was led by meningioma which had a high prevalence among the elderly population, followed by metastasis BT and gliomas.
METHODS: In this prospective study, 48 patients scheduled for elective laparotomy were randomized to two groups of preemptive analgesia, namely, group K-P, in which anestheologists administered a combination of 0.3 mg/kg IV ketamine and 40.0 mg IV parecoxib, or group K, in which ones gave 0.3 mg/kg IV ketamine alone. Patients from both groups underwent surgery under general anesthesia, and total intraoperative opioid requirement was recorded. After surgery, morphine administered by automated patient-controlled analgesia (PCA) infusion device was initiated in all patients. Pain score was assessed using the visual analogue scale (VAS), and postoperative opioid requirement was recorded at 1 and 4 hours, and subsequently from 4-hour intervals up to 24 hours after surgery.
RESULTS: Compared to group K, group K-P required significantly lower rescue IV fentanyl in the recovery bay (0.10 ± 0.28 vs. 0.35 ± 0.46 μg/kg; P = 0.031), showing prolonged time-to-first analgesic request recorded by PCA device (70.8 ± 40.0 vs. 22.2 ± 15.8 mins; P < 0.001), lower total morphine requirement delivered by PCA device (8.0 ± 4.6 vs. 16.8 ± 6.5 mg; P < 0.001), and lower VAS values measured at all time points. There was no significant difference in intraoperative total opioid requirement between the groups.
CONCLUSIONS: Among laparotomy patients, multimodal preemptive analgesia by the use of a combination of low-dose IV ketamine and IV parecoxib was more effective than IV ketamine alone in reducing pain scores and postoperative analgesia requirement (e.g., PCA-administered morphine).