Günübirlik operatif histeroskopi sonrası intravenöz parasetamol ve deksketoprofen trometamol\'ün analjezik etkinliklerinin karşılaştırılması: Randomize, çift kör, plasebo kontrollü çalışma

Amaç: Günübirlik ameliyatlardan sonra yeterli ağrı kontrolü hastaların erken taburcu olmalarında önemlidir. Çalışmamızda, operatif histeroskopi geçiren hastaların ameliyat sonrası ağrı tedavisinde intravenöz parasetamol ile intravenöz deksketopro- fen trometamolün analjezik etkinliklerini karşılaştırmayı planladık. Gereç ve Yöntem: Fakülte Etik Kurul izni (KA09/258) ve hasta onayı alındıktan sonra ayaktan, ASA I-II, genel anestezi altında operatif histeroskopi ameliyatı geçirecek 114 hasta ileriye yönelik, randomize olarak çalışmaya alındı. Hastalar üç gruba ayrıldı. Grup Dye iv. 50 mg deksketoprofen trometamol, Grup Pye iv. 1000 mg parasetamol ve Grup Cye iv. %0.9 NaCl tek doz olarak uygulandı. Ameliyat sonrası 15 dk, 30 dk, 1 s, 2 s ve 3. slerde Görsel Ağrı Skalası (VAS) ile ağrı şiddeti, ağrı hafiflemesi, sedasyon, bulantı-kusma skorları, diğer yan etkiler ve ek analjezik ihtiyaçları kaydedildi. VAS ≥40 mm olan hastalara ek doz analjezik olarak iv. meperidin 0.25 mg/kg uygulandı. Bulgular: Görsel Ağrı Skalası skorları Grup Dde 15 dk,30 dk 1 s ve 2. s izlemde Grup Cye göre daha düşük; 15. dk ve 30. dk. Grup Pye göre daha düşük bulundu. Grup Dde Grup P ve Grup Cye göre opioid ihtiyacı olan hasta oranı (sırasıyla %34, %60, %63; p

Efficacy of intravenous dexketoprofen trometamol compared to intravenous paracetamol for postoperative pain management after day-case operative hysteroscopy: randomized, double-blind, placebo-controlled study

Objective: 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 hysteros- copy. Methods: One hundred and fourteen American Society of Anesthesiologists (ASA) I-II patients scheduled for day-case operative hys- teroscopy 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. Results: 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 treat- ment 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). Conclusion: Our study demonstrated that iv dexketoprofen has superior efficacy for postoperative pain management following day- case operative hysteroscopy when compared with paracetamol and placebo.

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