2018, Number 2
Rev Mex Anest 2018; 41 (2)
Treatment of postoperative pain in laparoscopic abdominal surgeries with dexketoprofen trometamol compared to ketorolac trometamine
Oriol-López SA, Hernández-Bernal CE, Aguilar-Juárez MI, Álvarez-Flores AA
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The laparoscopic abdominal surgeries are less painful that the open ones, however the irritation that produces the pneumoperitoneum is cause of important visceral pain in the first postoperative 24 hours, the proper medication decreases the complications, cost and hospital permanence. The treatment of postoperative pain includes anti-inflammatory non-steroidal analgesics; isomeric forms of drugs provide a more controlled profile and minimize adverse effects, as dexketoprofen, for quick action, so the control of postoperative pain in these surgeries will have better analgesic effect compared with ketorolac. We included 100 patients, scheduled for laparoscopic surgery, random in group I: supply dexketoprofen 50 mg every 12 hours, group II ketorolac 30 mg every 8 hours, with paracetamol and tramadol rescue if ≥ 4 EVA. The values percent of EVA obtained in I were minor, in them times measured; paracetamol rescue dose in 64% (1 and 2) in II 86% (1 to 4); the rescue application time in I 4.76 hours, II: 3.6 hours; obtaining p ‹ 0.000. The supply of dexketoprofen in laparoscopic surgery, is better option in the postoperative pain control.
Karaman Y, Çukurova I, Demirhan E, Gönüllü M, Altunbaş S. Efficacy of dexketoprofen trometamol for acute postoperative pain relief after ENT surgery: a comparison with paracetamol and metamizol. Nobel Med. 2010;6:47-52.
Philip J. Chirally pure non-steroidal anti-inflammatory drugs. Medicine Update. 2010;20:837-840.
Walzack JS. Analgesic properties of dexketoprofen trometamol. Pain Manag. 2011;1:409-416.
Leman P, Kapadia Y, Herington J. Randomised controlled trial of the onset of analgesic efficacy of dexketoprofen and diclofenac in lower limb injury. Emerg Med J. 2003;20:511-513.
Rodríguez MJ, Arbós RM, Amaro SR. Dexketoprofen trometamol: clinical evidence supporting its role as a painkiller. Expert Rev Neurother. 2008;8:1625-1640.
Burke D, Bannister J. Dexketoprofen trometamol in post-operative pain management. Acute Pain. 2003;5:57-62. doi: 10.1016/j.acpain.2003.09.001
Moore RA, Barden J. Systematic review of dexketoprofen in acute and chronic pain. BMC Clin Pharmacol. 2008;8:1-11.
Mugabure BB, González SS, Uría AA, Rubín NA, García SD, Azkona AM. Multimodal analgesia for the management of postoperative pain. http://dx.doi.org/10.5772/57401
Perrin M, Fletcher A. Laparoscopic abdominal surgery. Continuing Education in Anaesthesia, Critical Care & Pain. BJA Education. 2004;4:107-110.
Enciso NJ. Anestesia en la cirugía laparoscópica abdominal. An Fac Med. 2013;74:63-70.
Ekstein P, Szold A, Sagie B, Werbin N, Klausner JM, Weinbroum AA. Laparoscopic surgery may be associated with severe pain and high analgesia requirements in the immediate postoperative period. Ann Surg. 2006;243:41-46.
Hyung OK, Chang HY, Sung RL, Byung HS, Yong LP, Jun HS, et al. Pain after laparoscopic appendectomy: a comparison of transumbilical single-port and conventional laparoscopic surgery. J Korean Surg Soc. 2012;82:172-178.
Alexander JI. Pain after laparoscopy. Br J Anaesth. 1997;79:369-378.
Joris J, Thiry E, Paris P, Weerts J, Lamy M. Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine. Anesth Analg. 1995;81:379-384.
Sagiroglu G. Comparing early postoperative period analgesic effect of dexketoprofene trometamol and lornoxicam in mediastinoscopy cases. Eurasian J Med. 2011;43:23-26.
Pimple S, Maurya P, Salunke K, Singh R, Gurjar M, Shah M. Formulation development and compatibility study of dexketoprofen injection used in the management of post-operative pain. Int J Pharm Sci Rev Res. 2015;30:299-305.
Ecmeckçi P, Kazak BZ, Kazbek BK, Özis SE, Taştan H, Süer AH. The efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia technique in post-LC pain treatment. Agri. 2012;24:63-68.
Barden J, Derry S, McQuay HJ, Moore RA. Single dose oral ketoprofen and dexketoprofen for acute postoperative pain in adults. Cochrane Database Syst Rev. 2009;CD007355. doi: 10.1002/14651858.CD007355.pub2.
Piirainen A, Kokki H, Immonen S, Eskelinen M, Häkkinen MR, Hautajärvi H, et al. A dose-finding study of dexketoprofen in patients undergoing laparoscopic cholecystectomy: a randomized clinical trial on effects on the analgesic concentration of oxycodone. Drugs RD. 2015;15:319-328. doi: 10.1007/s40268-015-0107-7
Costea D, Gherghina V, Popescu R, Nicolae Gh., Cîndea Iulia, Balcan Alina. The effect of dexketoprofen pre-emptively administered on the consumption of tramadol and the incidence of nausea and vomiting after laparoscopic cholecystectomy. ARS Medica Tomitana. 2014;2:91-96.
Iohom G, Walsh M, Higgins G, Shorten G. Effect of perioperative administration of dexketoprofen on opioid requirements and inflammatory response following elective hip arthroplasty. Br J Anaesth. 2002;88:520-526.
Anıl A, Kaya FN, Yavaşcaoğlu B, Mercanoğlu Efe E, Türker G, Demirci A. Comparison of postoperative analgesic efficacy of intraoperative single-dose intravenous administration of dexketoprofen trometamol and diclofenac sodium in laparoscopic cholecystectomy. J Clin Anesth. 2016;32:127-133.