Department of Anesthesiology, Research and Training Hospital, Ministry of Health Ankara, Turkey.
J Neurosurg Anesthesiol. 2011 Jul;23(3):193-7. doi: 10.1097/ANA.0b013e31820d1ebb.
We investigated the postoperative analgesic efficacy and effect on total tramadol consumption of intravenous dexketoprofen trometamol, a new nonsteroidal anti-inflammatory drug, in patients that had undergone lumbar disc surgery.
Sixty patients were included in this placebo-controlled, randomized, double-blind study. General anesthesia was applied to both groups. Group D (n=30) received dexketoprofen (50 mg) intravenously 30 minutes before the end of surgery and at the postoperative 12th hour, whereas group C (n=30) received 2 mL of 0.9% NaCL intravenously at the same time points. All patients received a patient controlled analgesia device with a tramadol, 25 mg bolus, 15 minutes lockout protocol, and were followed with visual analog scale, verbal rating scale, modified Aldrete recovery scoring system, and Ramsay sedation scale in the postoperative period.
There was no significant difference between the groups for demographic data, duration of surgery, mean arterial pressure, and heart rate. The time to first postoperative analgesic requirement was significantly longer in group D (151.33±81.98 min) than group C (19±5.78 min) (P<0.001). Total tramadol consumption was significantly lower in group D (117.50±48.31 mg) than group C (311.67±59.35 mg) (P<0.05). Visual analog scale and verbal rating scale values in group D were significantly lower than group C at all follow-up periods (P<0.001). There was a significant difference between the groups for the modified Aldrete recovery scoring system (P<0.05) but not for Ramsay sedation scale. The instances of nausea and vomiting among the side effects were significantly lower in group D (P<0.05).
We found that dexketoprofen was an effective analgesic for postdiscectomy pain when used alone or in addition to opioids. It is easy to administer and decreases tramadol consumption and opioid-related side effects.
我们研究了静脉注射右旋酮洛芬氨丁三醇(一种新型非甾体抗炎药)在腰椎间盘手术后患者中的术后镇痛效果和对曲马多总消耗量的影响。
本研究为安慰剂对照、随机、双盲研究,纳入 60 例患者。两组患者均接受全身麻醉。D 组(n=30)在手术结束前 30 分钟和术后 12 小时静脉给予右旋酮洛芬(50mg),C 组(n=30)在相同时间点静脉给予 2mL 0.9%生理盐水。所有患者均使用曲马多、25mg 推注、15 分钟锁定的患者自控镇痛装置,并在术后使用视觉模拟评分、口头评分、改良 Aldrete 恢复评分系统和 Ramsay 镇静评分进行随访。
两组患者的人口统计学数据、手术时间、平均动脉压和心率无显著差异。D 组(151.33±81.98 分钟)首次术后镇痛需求时间明显长于 C 组(19±5.78 分钟)(P<0.001)。D 组(117.50±48.31mg)曲马多总消耗量明显低于 C 组(311.67±59.35mg)(P<0.05)。D 组在所有随访时间点的视觉模拟评分和口头评分均明显低于 C 组(P<0.001)。改良 Aldrete 恢复评分系统两组间有显著差异(P<0.05),但 Ramsay 镇静评分无显著差异。D 组恶心呕吐等不良反应发生率明显低于 C 组(P<0.05)。
我们发现右旋酮洛芬单独或联合阿片类药物用于腰椎间盘切除术后疼痛是一种有效的镇痛药物。它易于给药,可减少曲马多的消耗和阿片类药物相关的副作用。