Cuenca DJ, Morales VJ, Araujo RS

Language: Spanish
References: 16
Page: 11-15
PDF size: 49.43 Kb.

ABSTRACT

Objetive: To compare the efficiency of two analgesic therapies, one of them based on a NSAID (non-steroidal ainti-inflamatory drug) which specifically inhibits cyclooxigenase, administered as in-advance-analgesia at premedication in addition to ketorolaco or metamizol as rescue for analgesic claim, versus an scheduled-given NSAID scheme plus another NSAID in response to analgesic claim in the postoperative perioid, both being indicated by the surgical service from an emergency/general hospital. Besides, the economic cost of the two analgesic drug schemes used, was evaluated. Material and methods: It is a simple randomized, time -course followed, prospective and comparative study, of 40 patients that were accepted by the Trauma and Orthopedics Service (Upper Extremity) from the Hospital, which had an A.S.A. physical score E I and II B; distributed in two groups. Group A: 50 mg. P.O. of Rofecoxib was administered two hours previous to the beginning of the surgery and then 50 mg P.O. every 24 hrs for the consecutive two days. Group B: Metamizol 1 gr. I.V. was administered 20 minutes before the surgical procedure was completed and then every 8 hrs. Ketorolaco 30 mg. or Metamizol 1 g I.V. was administered in both groups according to patient´s analgesic claims and indications of the surgical service in the postoperative period. Heart rate, mean blood pressure, respiratory rate and pain were evaluated at 4, 8, 24, 32 and 48 hours after surgery; relief of pain sensibility and economic cost of whole analgesic requirement in each group were also evaluated.
Results: The differences in the hemodynamic variables, respiratory rate and score from the analog visual scale for the pain were not stadistically significative between the two groups; nevertheless, statistical significant differences were observed in the number of patients that experienced relief of pain sensibility at 48 hours after the surgery: group A 95% (19/20), and in group B 50% (10/20), p‹0.05. Also, a significant difference was found regarding the number of analgesic doses claimed by the patients in the postoperative period, with lower number of doses in group A; furthermore, whole cost of the analgesic treatment in group A was $414.00, while in group B was 1,170.00. Conclusion: Although the two postoperative analgesic treatment alternatives are appropiate, the management with Rofecoxib at the preanesthesic medication results in more patients with less pain after surgery, which suggests a higher economic benefits either for the patient and for the hospital.

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