Anıl Ali, Kaya Fatma Nur, Yavaşcaoğlu Belgin, Mercanoğlu Efe Esra, Türker Gürkan, Demirci Abdurrahman
Uludağ University Medical Faculty, Department of Anesthesiology and Reanimation, Nilüfer Bursa Turkey.
Uludağ University Medical Faculty, Department of Anesthesiology and Reanimation, Nilüfer Bursa Turkey.
J Clin Anesth. 2016 Aug;32:127-33. doi: 10.1016/j.jclinane.2016.02.020. Epub 2016 Apr 20.
The aim of this study is to compare the effects of intravenous single-dose dexketoprofen trometamol and diclofenac sodium 30 minutes before the end of the surgery on relief of postoperative pain in patients undergoing laparoscopic cholecystectomy.
A randomized fashion.
Sixty (American Society of Anesthesiologist class I-II) patients undergoing laparoscopic cholecystectomy were divided into 2 groups
Patients in group DT received 50 mg dexketoprofen trometamol, whereas patients in group DS received 75 mg diclofenac sodium, intravenously 30 minutes before the end of surgery.
Postoperative pain intensity, morphine consumption with patient-controlled analgesia, time to first analgesic requirement, complications, rescue analgesic (intravenous tenoxicam 20 mg) requirement, and duration of hospital stay were recorded.
Postoperative pain visual analog scale scores were similar in the follow-up periods (P > .05). Patient-controlled analgesia morphine consumption was significantly less in group DT compared with group DS in all postoperative follow-up periods (2 and 4 hours: P < .01; 8, 12, 18, and 24 hours: P < .001). In the postoperative period, the first analgesic requirement time was significantly longer in group DT compared with group DS (P < .01). In addition, the number of patients requiring rescue analgesic was higher in group DS compared with group DT (P < .01). Other follow-up parameters were similar.
In our study, administration of intravenous single-dose dexketoprofen trometamol 30 minutes before the end of surgery provided effective analgesia with reduced consumption of opioids and requirement for rescue analgesic compared with diclofenac sodium in patients undergoing laparoscopic cholecystectomy. For this reason, we believe that, as a part of multimodal analgesia, dexketoprofen trometamol provides more effective analgesia than diclofenac sodium in patients undergoing laparoscopic cholecystectomy.
本研究旨在比较在腹腔镜胆囊切除术结束前30分钟静脉注射单剂量右酮洛芬氨丁三醇和双氯芬酸钠对缓解术后疼痛的效果。
随机方式。
60例（美国麻醉医师协会分级I-II级）接受腹腔镜胆囊切除术的患者被分为2组。
DT组患者在手术结束前30分钟静脉注射50毫克右酮洛芬氨丁三醇，而DS组患者静脉注射75毫克双氯芬酸钠。
记录术后疼痛强度、患者自控镇痛时吗啡的消耗量、首次需要镇痛的时间、并发症、补救性镇痛（静脉注射20毫克替诺昔康）的需求以及住院时间。
在随访期间，术后疼痛视觉模拟量表评分相似（P>.05）。在所有术后随访期（2小时和4小时：P<.01；8、12、18和24小时：P<.001），DT组患者自控镇痛时吗啡的消耗量明显低于DS组。在术后阶段，DT组首次需要镇痛的时间明显长于DS组（P<.01）。此外，DS组需要补救性镇痛的患者数量高于DT组（P<.01）。其他随访参数相似。
在我们的研究中，对于接受腹腔镜胆囊切除术的患者，在手术结束前30分钟静脉注射单剂量右酮洛芬氨丁三醇与双氯芬酸钠相比，能提供有效的镇痛效果，减少阿片类药物的消耗和补救性镇痛的需求。因此，我们认为，作为多模式镇痛的一部分，右酮洛芬氨丁三醇在接受腹腔镜胆囊切除术的患者中比双氯芬酸钠能提供更有效的镇痛。
