Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
J Perianesth Nurs. 2022 Aug;37(4):540-544. doi: 10.1016/j.jopan.2021.10.018. Epub 2022 Mar 17.
Many different techniques, including multimodal analgesia, have been used for the management of postoperative pain after Percutaneous nephrolithotomy (PCNL). Ketorolac, intravenous (IV) paracetamol, rofecoxib, and IV ibuprofen have been used as a part of a multimodal analgesic approach in different surgical procedures. However, the efficacy of IV ibuprofen has not been well elucidated in adult patients undergoing elective PCNL. The aim of the study was to examine the efficacy of IV ibuprofen compared to IV paracetamol after elective PCNL.
This was a prospective randomized clinic study.
The study was conducted with 50 patients scheduled for PNCL between the ages of 18 and 65. IV ibuprofen 800 mg infusion was used for Group I, and 1 g IV paracetamol infusion Group P. IV tramadol infusion was administered with a Patient Controlled Analgesia device for postoperative analgesia. The primary outcome was 24-hour tramadol consumption. Secondary outcomes were pain intensity and side effects of the drugs. All outcomes were recorded in the 30th minute in the PACU and in 2, 4, 6, 12, 24 hours postoperatively.
Total postoperative tramadol consumption was significantly lower in Group I compared with Group P (P = .031). There was also a significant decrease in the cumulative tramadol consumption between the two groups in the 2nd and 24th hours (P < .012). In all measurement periods, pain intensity, sedation score, nausea and vomiting, itching, additional analgesia, and satisfaction with pain management were similar between the two groups.
IV ibuprofen, used as a part of multimodal tramadol-based analgesia reduced tramadol consumption compared with IV paracetamol in the first 24 hours postoperatively after elective PCNL. The IV ibuprofen-tramadol combination seems appeared superior to a paracetamol-tramadol combination.
经皮肾镜碎石取石术（PCNL）后，有许多不同的技术，包括多模式镇痛，被用于术后疼痛管理。酮咯酸、静脉内（IV）扑热息痛、罗非昔布和 IV 布洛芬已被用于不同手术的多模式镇痛方法的一部分。然而，IV 布洛芬在接受择期 PCNL 的成年患者中的疗效尚未得到充分阐明。本研究的目的是检查 IV 布洛芬与 IV 扑热息痛在择期 PCNL 后的疗效。
这是一项前瞻性随机临床研究。
该研究纳入了 50 名年龄在 18 至 65 岁之间的计划接受 PNCL 的患者。I 组给予 IV 布洛芬 800mg 输注，P 组给予 1g IV 扑热息痛输注。术后镇痛采用患者自控镇痛仪给予 IV 曲马多输注。主要结局是 24 小时曲马多消耗量。次要结局是疼痛强度和药物的副作用。所有结局均在 PACU 中的 30 分钟和术后 2、4、6、12、24 小时进行记录。
与 P 组相比，I 组患者的总术后曲马多消耗量明显降低（P=0.031）。两组患者在第 2 小时和第 24 小时的累积曲马多消耗量也有显著下降（P<0.012）。在所有测量时间段内，两组患者的疼痛强度、镇静评分、恶心呕吐、瘙痒、额外镇痛和对疼痛管理的满意度均相似。
与 IV 扑热息痛相比，在择期 PCNL 后 24 小时内，作为基于曲马多的多模式镇痛的一部分，IV 布洛芬可减少曲马多的消耗。IV 布洛芬-曲马多联合似乎优于扑热息痛-曲马多联合。
