Preemptive Analgesia with a Second Dose of Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan: A Comparative Clinical Trial in Major Surgeries.

BACKGROUND: Postoperative pain management can improve patients' quality of life and decrease hospitalization rates. Preemptive analgesia may provide an effective approach for both pain control and opioid consumption decrease. A common approach for pain management after surgery is to relieve the pain that has already occurred. OBJECTIVES: The aim of this clinical trial was to compare the preemptive analgesic effect of single-dose versus two-dose administration of pregabalin, acetaminophen, naproxen, and dextromethorphan (PAND) combination. METHODS: This study involved 60 patients who had undergone one surgery (including nephrectomy, cystectomy, prostatectomy, colectomy, Whipple, and RPLND). They were randomly divided into two groups: The first group received a single dose of PAND, while the other group received a second dose within 6 hours after discharge from recovery. Pain intensity was assessed by the Universal Pain Assessment Tool (UPAT) in both groups 2, 4, 6, 8, 12, 24, and 48 hours postoperatively. The postoperative morphine dose in both groups was also recorded. Data were analyzed using SPSS version 25. RESULTS: Mean pain scores were significantly different between the two groups at 2, 12, 24, and 48 hours after surgery (P < 0.05). There was a statistically significant difference between the two groups in terms of opioid consumption (P < 0.001). The total opioid consumption in the second group (with the second administration of PAND) was lower than the first group. CONCLUSIONS: Preemptive analgesia with a second dose of PAND is an effective method for reducing pain and morphine consumption after surgery.

Identification of volatile organic compounds in flowers of Astragalus lagopoides.

Composition of volatile organic compounds (VOCs) in flowers of Astragalus lagopoides was studied using a hydrodistillation extraction procedure coupled with gas chromatography-mass spectrometry. The analyses allowed the identification of a number of 25 compounds, among which the presence of several bioactive aromatic derivatives such as guaiacol, eugenol, linalool, α- and 4-terpineol as well as nerol was attention-grabbing. Moreover, some other compounds like cyclohexane, 2-bromoethyl with repellent function also appeared to be present in the flower. As a result, the floral VOCs profile of A. lagopoides might reflect an adaptation to attract specialised pollinator insects. These findings provide important information for advances in understanding the ecological and evolutionary perspectives of pollination biology of the giant genus Astragalus.