Alam K, Takrouri M S
Anesthesia section, King Abdel-Aziz University Hospital, Riyadh.
Middle East J Anaesthesiol. 1999 Feb;15(1):31-8.
Administration of analgesics before surgery can decrease the intra-operative anesthetic requirement and pain during the early post-operative period (pre-emptive analgesia). The objective of this study was to evaluate an intra-muscular preparation of ketoprofen as analgesic in mild to moderate pain in children. In a double-blind placebo-controlled study, 91 healthy ASA I or II children undergoing squint opthalmic surgery was undertaken in the Ophthalmic Services at King Abdel-Aziz University Hospital Riyadh. The postoperative analgesic effects of intra-muscular pethidine and ketoprofen, just after the induction of anesthesia were compared. Patients were randomized to receive ketoprofen (1 mg W kg-1), pethidine (1 mg W kg-1) or saline (0.1 ml W kg-1). Anesthesia was induced and maintained with halothane and nitrous oxide via a facemask. Post-operative pain was assessed by a blinded observer using an objective pain scale. Results revealed that the ketoprofen group had lower post-operative pain scores and required less frequent analgesic therapy in the early postoperative period compared to the pethidine and placebo groups. In contrast, there were no differences in pain scores or analgesic requirements between the pethidine and the placebo groups. It is concluded that the preoperative administration of intramuscular ketoprofen, but not pethidine, provided better postoperative pain control than placebo in children undergoing ophthalmic surgery.
手术前使用镇痛药可降低术中麻醉需求以及术后早期的疼痛程度(超前镇痛)。本研究的目的是评估酮洛芬肌内注射制剂对儿童轻至中度疼痛的镇痛效果。在一项双盲安慰剂对照研究中,在利雅得阿卜杜勒 - 阿齐兹国王大学医院眼科服务部,对91例接受斜视眼科手术的健康ASA I或II级儿童进行了研究。比较了麻醉诱导后肌内注射哌替啶和酮洛芬的术后镇痛效果。患者被随机分为接受酮洛芬(1 mg/kg)、哌替啶(1 mg/kg)或生理盐水(0.1 ml/kg)组。通过面罩用氟烷和氧化亚氮诱导并维持麻醉。由一位不知情的观察者使用客观疼痛量表评估术后疼痛。结果显示,与哌替啶组和安慰剂组相比,酮洛芬组术后疼痛评分更低,且术后早期所需的镇痛治疗频率更低。相比之下,哌替啶组和安慰剂组在疼痛评分或镇痛需求方面没有差异。结论是,对于接受眼科手术的儿童,术前肌内注射酮洛芬而非哌替啶,比安慰剂能提供更好的术后疼痛控制。