Gómez-Rojas JP

Language: Spanish
References: 15
Page: 32-36
PDF size: 83.32 Kb.

ABSTRACT

Introduction: Pain is a major postoperative discomfort, statistically, is the least attended and most difficult to resolve in the first 24 hours. We evaluated two alternatives: tramadol-ketorolaco versus tramadol-dexketoprofen to determine which provides better analgesia postoperatively in these patients. Sample: 60 patients divided into two groups (random). Methodology: Group A received at the beginning of surgery 30 mg + 100 mg IV ketorolac-tramadol, and a continuous infusion by electronic pump for 24 hours, which contained 90 mg ketorolac + 200 mg of tramadol with 250 mL volumetric saline. Group B received at the beginning of surgery 50 mg dexketoprofen + tramadol 100 mg IV, and began a continuous infusion by electronic pump for 24 hours, which contained 100 mg of dexketoprofen + 200 mg of tramadol graduated with 250 mL of saline. We assessed pain intensity using the EVA at 6, 12, 18 and 24 hours postoperatively, we determined if there was mild pain (EVA 0-4), moderate pain (EVA 5-7) or severe pain (EVA 8-10). We assessed adverse effects and if allowed analgesia for postoperative ambulation at 24 hours. Statistical analyzes were: mean, standard Chi square and Student t test. Results: At 6 pm, the Group A had mild pain in 76% and moderate pain in 24%, Group B presented mild pain in 86% and moderate pain in 14%. At 12 hours, in Group A was presented mild pain in 58% and moderate in 42%, in Group B showed mild pain in 85% and moderate pain in 15%. At 18 hours, in Group A, the pain was mild in 52% and moderate in 48%, in Group B the pain was mild in 78% and moderate in 22%. A 24 hours in Group A, mild pain occurred in 58% and pain moderate in 42% in Group B had mild pain in 64% and moderate in 36%. Adverse effects were nausea, present in 6% of Group A and in 5% of Group B. With regard to ambulation 24 hours with walker in Group A was possible in 57% of this percentage, 42% had mild pain on walking, moderate pain 28%, and 30% had severe pain. In Group B, ambulation was possible in 64%, of which 53% had mild pain, 18% moderate pain and 19% severe pain. Conclusion: Although both groups presented moderate pain, the combination tramadol-dexketoprofen presented analgesic effect of higher quality, consistent and with fewer side effects. It also allowed a greater proportion of early ambulation and less pain. By itself, early ambulation in these patients decreases the incidence of complications such as paralytic ileus, thrombosis, pneumonia, etc.

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