Analgesia pós-operatória em cesarianas com a associação de morfina por via subaracnóidea e antiinflamatório não esteróide: diclofenaco versus cetoprofeno

Abstract

When associated to low spinal morphine doses, ketoprofen was similar to diclofenac in providing postoperative analgesia in the first six hours following Cesarean section under spinal anesthesia.

Comparison of different nonsteroidal anti-inflammatory drugs for cesarean section: a systematic review and network meta-analysis

“…The findings of the risk of bias assessment are presented in Figure 2. Overall, only four trials were deemed to be at low risk of bias [10, 54,55,68], and 30 and 13 of the remaining trials were evaluated to have some concerns [25,[27][28][29][30][31][32][33][34][35]37,38,[43][44][45]47,49,52,53,[57][58][59][60][61][62][63][64][65][66][67]] or be at high risk of bias [11,26,36,[39][40][41][42]46,48,50,51,56,69], respectively. Many of the concerns were related to the randomization process, measurement of the outcome and the selection of the reported result.…”

“…In addition to NSAIDs, women received propacetamol or paracetamol in four trials [32,33,37,57]. The route of administration of NSAIDs was as follows: oral in two trials [35,46]; intramuscular in 13 trials [25,27,28,31,34,36,38,40,43,49,[65][66][67]; intravenous in 16 trials [10,11,39,45,[50][51][52][53]55,56,[58][59][60][61][62]64]; rectal in 11 trials [26,29,30,32,33,41,42,44,48,68,69]; oral or intramuscular in one trial [47]; intravenous and oral in one trial [57]; intramuscular or intravenous in one trial [63]; and rectal and oral in two trials [37,…”

“…1 . The following interventions were compared: control vs. celecoxib in two trials [ 35 , 46 ]; control vs. celecoxib + parecoxib in one trial [ 57 ]; control vs. diclofenac in 24 trials [ 11 , 25 – 34 , 36 – 43 , 65 – 69 ]; control vs. diclofenac vs. indomethacin in one trial [ 44 ]; control vs. diclofenac vs. ketoprofen in one trial [ 45 ]; control vs. ibuprofen vs. ketorolac in one trial [ 47 ]; control vs. indomethacin in one trial [ 48 ]; control vs. ketorolac in six trials [ 10 , 49 – 53 ]; control vs. naproxen in one trial [ 54 ]; control vs. parecoxib in one trial [ 55 ]; control vs. tenoxicam in six trials [ 56 , 58 – 62 ]; diclofenac vs. ketoprofen in one trial [ 63 ]; and ketorolac vs. parecoxib in one trial [ 64 ]. The findings of the risk of bias assessment are presented in Fig.…”

“…Characteristics of the trials are presented in Table 1 . In regard to the nature of the cesarean section, it was elective, elective or emergent, and not specified in 30 [ 10 , 26 , 29 , 31 – 35 , 37 , 38 , 45 , 48 – 51 , 53 – 58 , 60 – 62 , 64 – 69 ], six [ 11 , 30 , 40 – 43 ], and 11 [ 25 , 27 , 28 , 36 , 39 , 44 , 46 , 47 , 52 , 59 , 63 ] trials, respectively. The mode of anesthesia was spinal, combined spinal-epidural (CSE), epidural, or general anesthesia in 27 [ 10 , 11 , 29 , 32 – 35 , 37 – 39 , 41 – 44 , 46 , 48 , 50 , 54 – 56 , 60 – 64 , 68 , 69 ], two [ 51 , 57 ], three [ 49 , 66 , 67 ], and 11 [ 25 – 28 , 30 , 31 , …”

“…The route of administration of NSAIDs was as follows: oral in two trials [ 35 , 46 ]; intramuscular in 13 trials [ 25 , 27 , 28 , 31 , 34 , 36 , 38 , 40 , 43 , 49 , 65 – 67 ]; intravenous in 16 trials [ 10 , 11 , 39 , 45 , 50 – 53 , 55 , 56 , 58 – 62 , 64 ]; rectal in 11 trials [ 26 , 29 , 30 , 32 , 33 , 41 , 42 , 44 , 48 , 68 , 69 ]; oral or intramuscular in one trial [ 47 ]; intravenous and oral in one trial [ 57 ]; intramuscular or intravenous in one trial [ 63 ]; and rectal and oral in two trials [ 37 , 54 ]. In 21 trials, just one dose of NSAIDs was administered [ 10 , 11 , 26 , 35 , 36 , 39 , 46 , 49 , 55 , 56 , 58 – 63 , 65 – 69 ] and in further 21 trials, more than one dose or an infusion of NSAIDs was given [ 25 , 29 – 3...…”