medigraphic.com
SPANISH

Revista Mexicana de Anestesiología

ISSN 3061-8142 (Electronic)
ISSN 0484-7903 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2021, Number 1

<< Back Next >>

Rev Mex Anest 2021; 44 (1)

Preventive versus postoperative analgesia with paracetamol + ketorolac in laparoscopic cholecystectomy

Román-Romero J, Córdova-González I
Full text How to cite this article 10.35366/97772

DOI

DOI: 10.35366/97772
URL: https://dx.doi.org/10.35366/97772

Language: Spanish
References: 10
Page: 8-12
PDF size: 231.23 Kb.


Key words:

Preventive analgesia, postoperative analgesia, paracetamol, ketorolac, laparoscopic cholecystectomy.

ABSTRACT

Introduction: Preventive analgesia is the administration of a drug or performance of an intervention capable of inhibiting or blocking the painful response in order to prevent the pain associated with a surgical procedure. Objective: To identify whether there are differences in postoperative pain control using preventive analgesia versus postoperative analgesia, managed with paracetamol + ketorolac in patients undergoing elective laparoscopic cholecystectomy. Material and methods: Controlled clinical trial, randomized, longitudinal, unicentric, prolective, homodemic, double blind; 70 patients divided into two groups. group 1 received preventive analgesia using paracetamol + ketorolac and group 2 same scheme in an immediate postsurgical manner. Bloodpressure, heartrate, numerical verbal scale of pain and presence of side effects of drugs at different times were measured. Student's t-test with statistical significance of p < 0.05. Results: At 60 minutes the diastolic blood pressure in group 1 had difference of means -4.20 with p = 0.027 and numerical verbal scale presented difference of means of -0.71 and p = 0.002. At four hours diastolic bloodpressure showed difference of means of -3.5 and p = 0.033. Nausea was reported in 2.9% for group 1 and 8.6% for group 2. Conclusions: There is a better response to pain in those patients who receive a preventive analgesia scheme compared to those who are administered an immediate post-surgical analgesia scheme.


REFERENCES

  1. Guía de Práctica Clínica. Diagnóstico y tratamiento de colecistitis y colelitiasis. Catálogo Maestro de Guías de práctica clínica IMSS-237-09.

  2. Rosa DJ, Navarrete SV, Diaz MM. Aspectos básicos del dolor postoperatorio y la analgesia multimodal preventiva. Rev Mex Anest. 2014;37:18-26.

  3. Covarrubias GA. El manejo del dolor agudo postoperatorio. Rev Mex de Anest. 2013;36:S179-S182.

  4. Rosero EB, Joshi GP. Preemptive, preventive, multimodal analgesia: what do they really mean? Plast Reconstr Surg. 2014;134:85S-93S.

  5. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T et al. Guidelines on the management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17:131-157.

  6. Chhaya VS, Vivek M. Paracetamol: mechanisms and updates. Continuing education in anaesthesia. Critical Care & Pain J. 2014;14:153-158.

  7. Nir RR, Nahman-Averbuch H, Moont R. Preoperative preemptive drug administration for acute postoperative pain: a systematic review and meta-analysis. Eur J Pain. 2016;20:1025-1043.

  8. Lee SK, Lee JL, Choy WS. Is multimodal analgesia as effective as postoperative patient-controlled analgesia following upper extremity surgery? Orthop Traumatol Surg Res. 2013;99:895-901.

  9. Katz J, Clarke H, Setzer Z. Preventive analgesia: quo vadimus? Anesth Analg. 2011;113:1242-1253.

  10. Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg. 2010;110:1170-1179.




Figure 1
Figure 2
Figure 3
Table 1
Table 2

2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Mex Anest. 2021;44