Postoperative analgesia following elective abdominal surgery: a prospective observational study

Background: Laparotomy forms an important subset of general surgical operations. This study aimed at collecting the baseline information on postoperative analgesia, to detect deficiencies in current management of postoperative pain and to aid as a reference for future endeavours aimed at improving pain management following abdominal surgeries.Methods: It was conducted as a prospective descriptive study in patients undergoing elective laparotomies in the Department of General Surgery of a tertiary care institute, for two years. The patterns of prescription and administration of analgesic drugs for postoperative pain after abdominal surgery, incidence and severity of postoperative pain, adverse effects of drugs and patient satisfaction were assessed.Results: A total of 289 elective laparotomies were performed. Combinations of Non-steroidal anti-inflammatory drugs (NSAID) with opioids, epidural analgesia (EA) with supplemental intramuscular ketorolac and PCEA (Patient controlled EA) provided effective pain relief with high satisfaction score (3/4) and were associated with low sedation (1/3) and the least side effects. Patients receiving NSAIDs had higher pain score with lesser satisfaction score and lower sedation score. IV-PCA with morphine provided effective pain relief with high satisfaction score (3/4), with least side effects, but patients had high sedation score (2/3). Around 55 (55/289; 19.03%) patients experienced postoperative nausea and vomiting, which responded to antiemetic treatment.Conclusions: A combination of NSAIDs with opioids provided effective pain relief, high satisfaction with less sedation and least side effects. Epidural analgesia with supplemental intramuscular ketorolac and PCEA also provided effective pain relief with high satisfaction and less sedation with least side effects.

Geospatial Crypto Reconnaissance: A Campus Self-Discovery Game

Campus discovery is an important feature of a university student induction process. Approaches towards campus discovery differ from course to course and can comprise guided tours that are often lengthy and uninspiring, or self-guided tours that run the risk of students failing to complete them. This paper describes a campus self-discovery induction game (Geospatial Crypto Reconnaissance) which aims to make students aware of campus resources and facilities, whilst at the same time allowing students to make friends and complete the game in an enthusing and exciting way. In this paper we describe the game construct, which comprises of a location, message, and artefact, and also the gameplay. Geospatial Crypto Reconnaissance requires students to identify a series of photographs from around the campus, to capture the GPS coordinates of the location of the photograph, to decipher a ciphered message and then to return both the GPS coordinates and the message for each photograph, proving that the student has attended the location. The game had a very high satisfaction score and we present an analysis of student feedback on the game and also provide guidance on how the game can be adopted for less technical cohorts of students.