[en] Objective: To compare intravenous lidocaine infusion adjunct to NSAID and Acetaminophen with regular analgesics for postoperative mean pain score and mean ambulation time after laparoscopic cholecystectomy. Study Design: Randomised controlled trial. Place and Duration of Study: Department of General Surgery, Islamabad Medical Complex, (IMC), from March 2020 to December 2021. Methodology: Sixty (n=60) adult patients, both males and females between the ages of 18-60 years planned for laparoscopic cholecystectomy, were selected and randomly allocated to two groups of treatment (Lidocaine and Ringer Lactate). The control group did not receive any other placebo other than Ringer Lactate infusion. Both groups received Intramuscular Diclofenac 12 hourly and intravenous acetaminophen infusion 8 hourly. Postoperative pain 2, 6, 12 and 24 hours (h) and mean ambulation time were compared in both groups. Results: Mean VAS (Visual Analogue Scale) of group 1 versus group 2 at 2 h, 6 h, 12 h and 24 h were 3.47 ± 0.82 vs. 6.27 ± 0.52 (p=<0.001), 2.7 ± 0.75 vs. 4.8 ± 0.8 (p<0.001), 2.0 ± 0.49 vs. 3.93 ± 0.94 (p<0.001), 0.73 ± 0.82 vs. 2.2 ± 0.61 (p<0.001). Time for spontaneous ambulation after surgery was 5.57 ± 1.55 hours for Group 1 versus 7.3 ± 1.9 hours for Group 2 (p<0.001). Conclusion: Pain scores at all-time intervals were lower, and ambulation time was shorter in patients who received intravenous infusion of lidocaine as compared to patients who received only regular analgesics for laparoscopic cholecystectomy. (author)

[en] Objective: To assess the outcome of percutaneous needle tenotomy in the treatment of resistant lateral epicondylitis Study design: Descriptive study Place and duration of study: Outpatient Department (OPD) of Orthopedics and Trauma Qazi Hussain Ahmad Medical Complex Nowshera and Private clinics in Kohat, KPK, Pakistan from January 2016 to December 2017. Materials and Methods: 20 patients with resistant lateral epicondylitis meeting the inclusion criteria were enrolled in the study. Each patient underwent percutaneous needle tenotomy of the common extensor tendon with 18G hypodermic needle under local anesthesia. Pre-procedure and post-procedure assessment at 12 weeks was doneusing VAS pain score and Nirschl stage. Results: Out of 20 patients, 16(80 percent) patients were females and 4(20 percent) were males. Average age of the patients was 40.75 years+- 8.03SD. In 17(85 percent) patients, right elbow was involved while in 3(15 percent) patients, left elbow was involved. Most of the patients (15, 75 percent) were in the age range of 30-50 years. Mean duration of symptoms was 31.85 weeks+-4.88SD. At 12 weeks, mean VAS pain score decreased from 8.05+-1.36SD to 1.35+-2.22SD while mean Nirschl stage decreased from 6.15+-0.85SD to 0.95+-1.63SD. There was statistically significant decrease in VAS pain score and Nirschl stage at 12 weeks (p-value <0.001). Treatment was successful in 70 percent (14) of patients (VAS pain score<- 2). Temporary pain at tenotomy site was reported by 2 (10 percent) patients. No case of hematoma formation or infection was reported. No patient was lost to follow up. Conclusion: Percutaneous needle tenotomy for resistant lateral epicondylitis is easy, safe, effective and minimally invasive procedure which can be done at outpatient department. We recommend long-term comparative study to confirm our results. (author)