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1 Tf 48 0 0 48 492.3061 2009.6 Tm 0 Tr /CS0 cs 1 scn -0.0002 Tc 0.0343 Tw (Incisional and )Tj -3.29468 -1.30283 TD (intraperitoneal local )Tj -4.13389 -1.30283 TD 0 Tc 0.034 Tw [(anaesthetics in lapar)18(oscopic)]TJ 3.8353 -1.30283 TD -0.0001 Tc 0.0343 Tw (cholecystectomy and)Tj -2.48413 -1.30283 TD -0.0002 Tc (abdominal hysterectomy: )Tj 2.87612 -1.30283 TD (a systematic review)Tj ET /GS2 gs BT /F1 1 Tf 15 0 0 15 869.8631 1623.2056 Tm 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 1623.2056 Tm 0 0 0 1 k 0.031 Tw [(Three studies \(3 ar)-8(ms\) examined pre-incisional LA)]TJ 0 -1.26666 TD -0.0001 Tc 0.0308 Tw (in AH)Tj 7.5 0 0 7.5 930.6596 1609.9868 Tm 0 Tc (8\32010)Tj 15 0 0 15 895.3669 1576.7018 Tm -0.0001 Tc Tj 1.51181 0.00001 TD 0 Tc 0.031 Tw [(all three studies repor)-20(ted no significant )]TJ 0 -1.26667 TD -0.0001 Tc 0.0308 Tw (benefit of LA over placebo for pain at rest)Tj -1.51181 -1.8336 TD 0 Tc 0.031 Tw [-673(quantitative analysis demonstrated no )]TJ 1.51181 -1.26666 TD -0.0001 Tc 0.0308 Tw (significant or clinically meaningful benefit up )Tj 0 -1.26667 TD (to 48 h (Figure 1b))Tj ET BT /F1 1 Tf 15 0 0 15 869.8631 1457.6073 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 1457.6073 Tm 0 0 0 1 k 0.031 Tw [(Eight studies \(9 ar)-8(ms\) examined post-incisional )]TJ 0 -1.26667 TD -0.0001 Tc 0.0308 Tw (LA in AH)Tj 7.5 0 0 7.5 951.8489 1444.3885 Tm 0 Tc (11\32018)Tj 15 0 0 15 895.3669 1411.1033 Tm 0.031 Tw [-673(of these, three studies showed a significant )]TJ 1.51181 -1.26666 TD -0.0001 Tc 0.0308 Tw (benefit of LA over placebo for pain at rest)Tj -1.51181 -1.83361 TD Tj 1.51181 -0.00001 TD (quantitative analysis demonstrated a )Tj 0 -1.26666 TD 0 Tc 0.031 Tw [(reduction in V)100(AS for post-incisional LA of )]TJ -0.0001 Tc 0.0308 Tw (5.0 at 4 h, 9.0 at 8 h, 4.8 at 24 h and )' 0 -1.26667 TD (3.9 at 48 h (Figure 1c))Tj ET BT /F3 1 Tf 16 0 0 16 869.8631 1271.1741 Tm 0.0278 Tw (Intraperitoneal local anaesthetic)Tj ET BT /F1 1 Tf 15 0 0 15 869.8631 1243.6702 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 1243.6702 Tm 0 0 0 1 k 0.031 Tw [(T)60(wenty-one studies \(29 ar)-8(ms\) examined )]TJ 0 -1.26666 TD -0.0001 Tc 0.0308 Tw (intraperitoneal LA in LC)Tj 7.5 0 0 7.5 1046.4087 1230.4514 Tm (4,19\32037)Tj 15 0 0 15 895.3669 1197.1664 Tm 0 Tc 0.031 Tw [-673(of these, 17 ar)-8(ms repor)-20(ted a significant )]TJ 1.51181 -1.26666 TD -0.0001 Tc 0.0308 Tw (benefit of LA over placebo )Tj -1.51181 -1.8336 TD 0 Tc 0.031 Tw [-673(quantitative analysis demonstrated a )]TJ 1.51181 -1.26666 TD [(reduction in pain at rest of 12.2 on the V)100(AS)]TJ 0 -1.26667 TD -0.0001 Tc 0.0308 Tw (scale at 1 h, 6.2 at 6 h, 4.0 at 12 h and )Tj 0 -1.26666 TD (0.9 at 24 h, with a 5.2 higher score than)Tj 0 -1.26667 TD (placebo at 48 h (Figure 2a))Tj -1.51181 -1.83359 TD Tj 1.51181 -0.00001 TD (benefits on movement-associated pain \(1)Tj 0 -1.26666 TD (study\) were 28.0 at 1 h, 12.0 at 4 h, 18.0)Tj (at 8 h and 7.0 at 12 h (Figure 2b))' ET BT /F1 1 Tf 15 0 0 15 869.8631 974.5679 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 974.5679 Tm 0 0 0 1 k 0.031 Tw [(T)60(wo studies \(2 ar)-8(ms\) examined intraperitoneal )]TJ 0 -1.26667 TD -0.0001 Tc 0.0308 Tw (LA in AH)Tj 7.5 0 0 7.5 951.8489 961.3492 Tm (38,39)Tj 15 0 0 15 895.3669 928.0638 Tm 0 Tc 0.031 Tw [-673(of these, one study showed a significant )]TJ 1.51181 -1.26666 TD [(benefit at 24 h and 48 h for V)100(AS pain scores)]TJ -0.0001 Tc 0.0308 Tw (at rest)' -1.51181 -1.83359 TD 0 Tc 0.031 Tw [-673(quantitative data were only available from )]TJ 1.51181 -1.26667 TD -0.0001 Tc 0.0308 Tw (8 h showing a reduction in score of 6.1 at)Tj 0 -1.26666 TD (rest and 4.9 on movement at 8 h, 4.8 and)Tj (6.1 at 24 h and 4.9 and 5.2 at 48 h,)' 0 -1.26667 TD (respectively (Figures 2c and 2d))Tj ET /CS0 CS 1 SCN 869.863 738.7088 m 1219.359 738.7088 l S BT /F0 1 Tf 18 0 0 18 989.9211 744.5405 Tm 0 0 0 0.8 k (Conclusions)Tj ET BT /F1 1 Tf 15 0 0 15 869.8631 714.202 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 714.202 Tm 0 0 0 1 k -0.0001 Tc (Pre-incisional LA has a statistically significant)Tj 0 -1.26666 TD (effect following LC up to 24 h, which is of )Tj (borderline clinical significance. Data are not)' 0 -1.26667 TD (available on post-incisional LA in LC)Tj ET BT /F1 1 Tf 15 0 0 15 869.8631 623.1783 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 623.1783 Tm 0 0 0 1 k -0.0001 Tc (Although statistically significant benefits were)Tj 0 -1.26666 TD -0.0002 Tc (obser)Tj 2.43116 0.00001 TD -0.0001 Tc (ved at 8 h and 24 h for post-incisional )Tj -2.43116 -1.26668 TD (LA in AH, these benefits were not clinically )Tj 0 -1.26666 TD (meaningful. Pre-incisional LA has no significant )Tj (or clinically meaningful benefit in AH)' ET BT /F1 1 Tf 15 0 0 15 869.8631 513.1547 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 513.1547 Tm 0 0 0 1 k -0.0001 Tc (Intraperitoneal LA has a significant and clinically)Tj 0 -1.26666 TD (meaningful effect in reducing pain on movement)Tj (following LC; this benefit may extend to 12 h )' ET BT /F1 1 Tf 15 0 0 15 869.8631 441.131 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 441.131 Tm 0 0 0 1 k -0.0001 Tc (Data for the benefit of intraperitoneal LA in the)Tj 0 -1.26666 TD (early postoperative phase following AH \(up to )Tj 0 -1.26667 TD (8 h\) are lacking. There is no evidence of a )Tj 0 -1.26666 TD (clinically meaningful benefit on pain at rest or )Tj (on movement from 8\32048 h)' ET BT /F1 1 Tf 15 0 0 15 869.8631 331.1074 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 892.5403 331.1074 Tm 0 0 0 1 k -0.0063 Tc (These data suggest that incisional and )Tj 0 -1.26666 TD (intraperitoneal LA may have a role in the )Tj (management of postoperative pain in the first )' 0 -1.26667 TD -0.0186 Tc (12 hours following LC, but not following AH. These)Tj 0 -1.26666 TD -0.0063 Tc (data reinforce the need to examine the benefits of)Tj T* -0.006 Tc 0.031 Tw [(inter)-40(ventions on a procedure-specific basis)]TJ ET /GS0 gs 0.089 0.043 0.002 0.001 k 492.355 1472.6628 350.496 163.4091 re f q 492.355 1472.6628 350.496 163.4091 re W n /Fm0 Do Q /GS2 gs 1 w 0.89 0.43 0.02 0.01 K 492.355 1472.6628 350.496 163.4091 re s BT /F2 1 Tf 12 0 0 12 492.8553 1457.4451 Tm 0.89 0.43 0.02 0.01 k 0 Tc [(Figure 1a. Effect of pre-incisional LA on V)100(AS scores at rest )]TJ 0 -1.25 TD -0.0002 Tc 0.0308 Tw (following laparoscopic cholecystectomy)Tj ET /GS0 gs 0.089 0.043 0.002 0.001 k 492.355 1262.4988 350.496 163.409 re f q 492.355 1262.4988 350.496 163.409 re W n /Fm2 Do Q /GS2 gs 492.355 1262.4988 350.496 163.409 re s BT /F2 1 Tf 12 0 0 12 492.8553 1248.0784 Tm 0.89 0.43 0.02 0.01 k 0 Tc 0.031 Tw [(Figure 1b. Effect of pre-incisional LA on V)100(AS scores at rest )]TJ 0 -1.25 TD -0.0002 Tc 0.0308 Tw (following abdominal hysterectomy)Tj ET /GS0 gs 0.089 0.043 0.002 0.001 k 492.355 1054.5948 350.496 163.409 re f q 492.355 1054.5948 350.496 163.409 re W n /Fm4 Do Q /GS2 gs 492.355 1054.5948 350.496 163.409 re s /GS0 gs 492.355 845.3448 350.496 163.41 re f q 492.355 845.3448 350.496 163.41 re W n /Fm6 Do Q /GS2 gs 492.355 845.3448 350.496 163.41 re s /GS0 gs 492.355 625.8679 350.496 173.6549 re f q 492.355 625.8679 350.496 173.6549 re W n /Fm8 Do Q /GS2 gs 492.355 625.8679 350.496 173.6549 re s /GS0 gs 492.355 416.2159 350.496 163.409 re f q 492.355 416.2159 350.496 163.409 re W n /Fm10 Do Q /GS2 gs 492.355 416.2159 350.496 163.409 re s BT /F2 1 Tf 12 0 0 12 492.8553 1039.7349 Tm 0.89 0.43 0.02 0.01 k 0 Tc 0.031 Tw [(Figure 1c. Effect of post-incisional LA on V)100(AS scores at rest )]TJ 0 -1.25 TD -0.0002 Tc 0.0308 Tw (following abdominal hysterectomy)Tj 0 -16.12683 TD 0 Tc 0.031 Tw [(Figure 2a. Effect of intraperitoneal LA on V)100(AS scores at rest )]TJ 0 -1.25 TD -0.0002 Tc 0.0308 Tw (following laparoscopic cholecystectomy)Tj 0 -17.07975 TD 0 Tc 0.031 Tw [(Figure 2b. Effect of intraperitoneal LA on V)100(AS scores on movement)]TJ 0 -1.25 TD -0.0002 Tc 0.0308 Tw (following laparoscopic cholecystectomy)Tj 0 -16.14891 TD -0.0001 Tc (Figure 2c. Effect of intraperitoneal LA on V)Tj 18.58149 0.00001 TD (AS scores at rest )Tj -18.58149 -1.25001 TD -0.0002 Tc (following abdominal hysterectomy)Tj ET /GS0 gs 0.089 0.043 0.002 0.001 k 492.355 205.9008 350.496 163.4101 re f q 492.355 205.9008 350.496 163.4101 re W n /Fm12 Do Q /GS2 gs 492.355 205.9008 350.496 163.4101 re s BT /F2 1 Tf 12 0 0 12 492.8553 191.7518 Tm 0.89 0.43 0.02 0.01 k -0.0001 Tc (Figure 2d. Effect of intraperitoneal LA on V)Tj 18.68256 0.00001 TD -0.0002 Tc (AS scores on movement )Tj -18.68256 -1.25001 TD (following abdominal hysterectomy)Tj ET /GS0 gs q 905.873 1915.2728 372.0421 211.029 re W n /Fm14 Do Q /GS2 gs BT /F0 1 Tf 13 0 0 13 964.2309 1773.3715 Tm 0 0 0 0.8 k 0.0343 Tw (Narinder Rawal)Tj 6.5 0 0 6.5 1073.9673 1778.4651 Tm 0 Tc (1)Tj 13 0 0 13 1083.3267 1773.3715 Tm -0.0001 Tc (and Ror)Tj 4.21421 -0.00002 TD 0 Tc 0.034 Tw [(y F)129(. McCloy)]TJ 6.5 0 0 6.5 1214.9016 1778.4651 Tm (2)Tj 13 0 0 13 895.8063 1757.3715 Tm -0.0001 Tc 0.0343 Tw (on behalf of the PROSPECT \(PROcedure-SPECific )Tj -1.38832 -1.23078 TD 0 Tc 0.034 Tw [(postoperative pain managemenT\) W)40(orking Gr)17(oup)]TJ ET BT /F6 1 Tf 5 0 0 5 904.9668 1724.4299 Tm (1)Tj 10 0 0 10 907.7463 1720.8674 Tm 0.028 Tw [(Department of Anaesthesia and Intensive Car)18(e, University Hospital, )]TJ 7.16678 -1.2 TD [<8572>17(ebr)18(o, Sweden; )]TJ 5 0 0 5 1060.1797 1712.4299 Tm (2)Tj 10 0 0 10 1062.9594 1708.8674 Tm [(University Department of Surgery)92(, )]TJ -5.23506 -1.2 TD [(Manchester Royal Infirmary)92(, Manchester)91(, UK.)]TJ ET 2 w /CS0 CS 1 SCN 115.847 1614.5459 m 465.343 1614.5459 l S BT /F0 1 Tf 18 0 0 18 233.851 1620.3774 Tm 0 Tw [(Backgr)18(ound)]TJ ET BT /F1 1 Tf 15 0 0 15 115.8474 1590.0389 Tm /CS0 cs 1 scn (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 1590.0389 Tm 0 0 0 1 k -0.0001 Tc 0.0308 Tw (In patients undergoing abdominal procedures,)Tj 0 -1.26667 TD (the administration of subcutaneous and )Tj 0 -1.26666 TD (intrafascial wound infiltration with local )Tj (anaesthetic (LA), or the instillation of LA by the)' 0 -1.26667 TD (intraperitoneal route, has the potential to reduce)Tj 0 -1.26666 TD 0 Tc 0.031 Tw [(postoperative pain and lower supplementar)-40(y)]TJ -0.0001 Tc 0.0308 Tw (analgesia requirements)' ET BT /F1 1 Tf 15 0 0 15 115.8474 1441.4482 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 1441.4482 Tm 0 0 0 1 k 0.031 Tw [(However)60(, evidence from clinical studies for the)]TJ 0 -1.26666 TD -0.0001 Tc 0.0308 Tw (efficacy of LA administered by these routes has)Tj (been conflicting)' ET BT /F1 1 Tf 15 0 0 15 115.8474 1368.8579 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 1368.8579 Tm 0 0 0 1 k 0.031 Tw [(In order to examine this question more closely)80(, )]TJ 0 -1.26667 TD -0.0001 Tc 0.0308 Tw (a systematic review of the effects of incisional)Tj 0 -1.26666 TD (and intraperitoneal LA in two common )Tj 0 -1.26667 TD (procedures, laparoscopic cholecystectomy )Tj ((LC) and abdominal hysterectomy (AH), was )' 0 -1.26666 TD (conducted)Tj ET BT /F1 1 Tf 15 0 0 15 115.8474 1239.2672 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 1239.2672 Tm 0 0 0 1 k -0.0001 Tc (The aim of this review was to examine the )Tj 0 -1.26667 TD 0 Tc 0.031 Tw [(patter)-8(n of effect of incisional and intraperitoneal)]TJ 0 -1.26666 TD [(LA on visual analogue scale \(V)100(AS\) pain scores )]TJ -0.0001 Tc 0.0308 Tw (for the first two postoperative days following)' 0 -1.26667 TD (these two different surgical procedures, and )Tj 0 -1.26666 TD (to review whether the effects of LA differed in)Tj (these procedures)' ET 115.847 1073.1648 m 465.343 1073.1648 l S BT /F0 1 Tf 18 0 0 18 250.3635 1078.9957 Tm 0 0 0 0.8 k (Methods)Tj ET BT /F1 1 Tf 15 0 0 15 115.8474 1048.6572 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 1048.6572 Tm 0 0 0 1 k -0.0001 Tc (Systematic reviews were conducted using the)Tj 0 -1.26666 TD (methods of the Cochrane Collaboration)Tj 7.5 0 0 7.5 397.4373 1035.4386 Tm 0 Tc (1)Tj ET BT /F1 1 Tf 15 0 0 15 115.8474 995.0668 Tm /CS0 cs 1 scn (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 995.0668 Tm 0 0 0 1 k -0.0001 Tc (MEDLINE and EmBASE were searched from)Tj 0 -1.26667 TD (1966\320June 2003 (LC) and 1966\320Jan 2004 (AH))Tj 0 -1.26666 TD (using pre-defined search criteria, and reference)Tj (lists of identified studies were also searched for)' 0 -1.26667 TD 0 Tc 0.031 Tw [(fur)-20(ther references)]TJ ET BT /F1 1 Tf 15 0 0 15 115.8474 884.4761 Tm /CS0 cs 1 scn (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 884.4761 Tm 0 0 0 1 k -0.0001 Tc 0.0308 Tw (Studies eligible for inclusion were randomised )Tj 0 -1.26666 TD (trials of intraperitoneal or incisional LA compared)Tj (with placebo in which all patients, or a definable)' 0 -1.26667 TD 0 Tc 0.031 Tw [(subgroup, under)-40(went LC or AH)]TJ ET BT /F1 1 Tf 15 0 0 15 115.8474 792.8857 Tm /CS0 cs 1 scn (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 792.8857 Tm 0 0 0 1 k -0.0001 Tc 0.0308 Tw (The use of a visual analogue scale \(V)Tj 16.25776 0.00001 TD (AS\) or )Tj -16.25776 -1.26668 TD (verbal rating scale (VRS) was required for )Tj 0 -1.26666 TD 0 Tc 0.031 Tw [(inclusion. VRS scores were conver)-20(ted to V)100(AS)]TJ -0.0001 Tc 0.0308 Tw (scores (0\320100 mm scale))' ET BT /F1 1 Tf 15 0 0 15 115.8474 701.295 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 701.295 Tm 0 0 0 1 k -0.0001 Tc (Qualitative and quantitative (meta-analyses))Tj 0 -1.26667 TD (analyses were conducted)Tj ET BT /F1 1 Tf 15 0 0 15 115.8474 647.7045 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 647.7045 Tm 0 0 0 1 k -0.0001 Tc (Meta-analysis was conducted on mean)Tj 0 -1.26666 TD (differences in postoperative V)Tj 12.8409 0.00001 TD (AS scores, grouped)Tj -12.8409 -1.26667 TD (by time postoperatively)Tj 10.01592 0.00001 TD 0 Tc 0.031 Tw [(. Outcomes were repor)-20(ted)]TJ -10.01592 -1.26668 TD -0.0001 Tc 0.0308 Tw (as weighted mean differences (WMD) with 95%)Tj 0 -1.26666 TD 0 Tc 0.031 Tw [(confidence inter)-40(vals)]TJ ET BT /F1 1 Tf 15 0 0 15 115.8474 537.114 Tm /CS0 cs 1 scn (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 537.114 Tm 0 0 0 1 k -0.0001 Tc 0.0308 Tw (A difference between LA and placebo of 13)Tj 0 -1.26666 TD (points on the V)Tj 6.48347 0.00001 TD (AS scale was repor)Tj 8.55379 0.00001 TD (ted as being)Tj -15.03727 -1.26668 TD (clinically meaningful)Tj 7.5 0 0 7.5 271.5877 504.8952 Tm 0 Tc (2)Tj ET 115.847 446.9539 m 465.343 446.9539 l S BT /F0 1 Tf 18 0 0 18 257.8694 452.8425 Tm 0 0 0 0.8 k -0.0001 Tc (Results)Tj ET BT /F3 1 Tf 16 0 0 16 115.8474 420.6694 Tm 0 0 0 1 k 0.0278 Tw (Incisional local anaesthetic)Tj ET BT /F1 1 Tf 15 0 0 15 115.8474 393.1655 Tm /CS0 cs 1 scn 0 Tc (l)Tj ET BT /F2 1 Tf 15 0 0 15 138.5246 393.1655 Tm 0 0 0 1 k 0.031 Tw [(Five studies \(8 ar)-8(ms\) examined pre-incisional LA)]TJ 0 -1.26666 TD -0.0001 Tc 0.0308 Tw (in LC)Tj 7.5 0 0 7.5 171.8282 379.9466 Tm 0 Tc (3\3207)Tj 15 0 0 15 141.3511 343.2598 Tm 0.031 Tw [-673(of these, 5 ar)-8(ms repor)-20(ted a significant benefit)]TJ 1.51181 -1.26666 TD -0.0001 Tc 0.0308 Tw (of LA over placebo for pain at rest)Tj -1.51181 -2.06038 TD 0 Tc 0.031 Tw [-673(quantitative analysis of these studies )]TJ 1.51181 -1.26666 TD [(demonstrated a reduction in V)100(AS score at rest)]TJ 0 -1.26667 TD -0.0001 Tc 0.0308 Tw (of 13.9 at 3 h, 11.0 at 12 h, 12.1 at 24 h)Tj 0 -1.26666 TD (and 3.5 at 48 h (Figure 1a))Tj 12 0 0 12 493.9988 150.2714 Tm (Figures are weighted mean differences (WMD) and 95% )Tj 0 -1.16666 TD 0 Tc 0.031 Tw [(confidence inter)-40(vals. N values are the number of studies used in)]TJ 0 -1.16668 TD -0.0001 Tc 0.0308 Tw (each meta-analysis. Significance values are for the differences)Tj 0 -1.16666 TD (between LA and placebo.)Tj ET 0 0 0 0 k 69.379 15.169 772.511 32.7499 re f BT /F2 1 Tf 12 0 0 12 70.3785 36.9614 Tm 0 0 0 1 k (Presented at the XXIII Annual ESRA Congress, Athens, Greece, 8\32011 September 2004)Tj ET Q endstream endobj 24 0 obj << /SA false /OPM 1 /Type/ExtGState /OP false >> endobj 5 0 obj << /SA true /OPM 1 /Type/ExtGState /OP false >> endobj 25 0 obj << /SA false /OPM 1 /Type/ExtGState /OP true >> endobj 26 0 obj << /Nums[0<>] >> endobj 27 0 obj << /Differences[32/space 40/parenleft/parenright 45/hyphen/period 49/one/two 58/colon 66/B/C 69/E/F/G 73/I 77/M/N/O/P 82/R/S/T 87/W 97/a/b/c/d/e/f/g/h/i 107/k/l/m/n/o/p 114/r/s/t/u/v/w 121/y] /BaseEncoding/MacRomanEncoding /Type/Encoding >> endobj 28 0 obj << /Length1 3457 /Length 3457 /Subtype/Type1C >> stream KICYGT+Futura-BoldA?   r ?Copyright (c) 1987, 1991, 1993 Adobe Systems Incorporated. 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