Koçum Aysu, Sener Mesut, Izmirli Hatice, Haydardedeoğlu Bülent, Arıboğan Anış
Department of Anesthesiology and Reanimation, Başkent University Faculty of Medicine, Ankara, Turkey.
Department of Obstetrics and Gynecology, Başkent University Faculty of Medicine, Ankara, Turkey.
Agri. 2014;26(1):15-22. doi: 10.5505/agri.2014.85047.
Adequate pain management following day-case surgery allows early ambulation of patients. In this study, we aimed to compare postoperative analgesic efficacy of intravenous (iv) dexketoprofen vs. iv paracetamol following day-case operative hysteroscopy.
One hundred and fourteen American Society of Anesthesiologists (ASA) I-II patients scheduled for day-case operative hysteroscopy were recruited and randomized to three groups in the study. Group D received 50 mg iv dexketoprofen trometamol, Group P 1000 mg iv paracetamol and Group C normal saline solution. Visual Analogue Scale (VAS) pain intensity, pain relief, sedation, nausea-vomiting, other side effects, and additional opioid analgesic requirement were noted at postoperative 15 minutes (min), 30 min, 1 hour (h), 2 h, and 3 h. Patients with VAS>=40 mm received meperidine 0.25 mg/kg as rescue analgesic medication.
VAS scores at 15 min, 30 min, 1 h, and 2 h were significantly lower in Group D compared to Group C. VAS scores at 15 min and 30 min were significantly lower in Group D compared to Group P. The percentages of patients who required opioid treatment were 34%, 60%, and 63% in Groups D, P and C, respectively (p<0.05). Total delivered opioid dose was 0.10±0.16 mg/kg, 027±0.33 mg/kg and 0.28±0.25 mg/kg in Groups D, P and C, respectively (p<0.05). Pain relief score was significantly better in Group D at postoperative 15 min when compared with Group C (p<0.05).
Our study demonstrated that iv dexketoprofen has superior efficacy for postoperative pain management following day-case operative hysteroscopy when compared with paracetamol and placebo.
日间手术术后进行充分的疼痛管理可使患者早期活动。在本研究中,我们旨在比较日间宫腔镜手术后静脉注射右酮洛芬与静脉注射对乙酰氨基酚的术后镇痛效果。
招募114例拟行日间宫腔镜手术的美国麻醉医师协会(ASA)I-II级患者,并随机分为三组。D组静脉注射50mg右酮洛芬氨丁三醇,P组静脉注射1000mg对乙酰氨基酚,C组静脉注射生理盐水。分别于术后15分钟、30分钟、1小时、2小时和3小时记录视觉模拟评分(VAS)疼痛强度、疼痛缓解情况、镇静程度、恶心呕吐及其他副作用,以及额外使用阿片类镇痛药的需求。VAS评分≥40mm的患者接受0.25mg/kg哌替啶作为解救镇痛药。
与C组相比,D组在术后15分钟、30分钟、1小时和2小时的VAS评分显著更低。与P组相比,D组在术后15分钟和30分钟的VAS评分显著更低。D组、P组和C组需要阿片类药物治疗的患者百分比分别为34%、60%和63%(p<0.05)。D组、P组和C组的阿片类药物总给药剂量分别为0.10±0.16mg/kg、0.27±0.33mg/kg和0.28±0.25mg/kg(p<0.05)。与C组相比,D组在术后15分钟时的疼痛缓解评分显著更好(p<0.05)。
我们的研究表明,与对乙酰氨基酚和安慰剂相比,静脉注射右酮洛芬在日间宫腔镜手术后的术后疼痛管理方面具有更好的疗效。