Comparative study of analgesic efficacy and morphine‐sparing effect of intramuscular dexketoprofen trometamol with ketoprofen or placebo after major orthopaedic surgery

Abstract

Aims Multimodal analgesia is thought to produce balanced and effective postoperative pain control. A combined therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and opiates could result in synergistic analgesia by acting through different mechanisms. Currently there are very few parenterally administered NSAIDs suitable for the immediate postoperative period. Therefore, this study was undertaken to assess the analgesic efficacy, relative potency, and safety of parenteral dexketoprofen trometamol following major orthopaedic surgery. Methods One hundred and seventy-two patients elected for prosthetic surgery, were randomized to receive two intramuscular injections (12 hourly) of either dexketoprofen 50 mg, ketoprofen 100 mg or placebo in a double-blind fashion. Postoperatively, the patient's pain was stabilized, then they were connected to a patientcontrolled analgesia system (PCA) of morphine for 24 h (1 mg with 5 min lockout). Results The mean cumulative amount of morphine (CAM) used was of 39 mg in the dexketoprofen group and 45 mg in the ketoprofen group vs 64 mg in the placebo group. (Reduction in morphine use was approximately one-third between the active compounds compared with placebo (adjusted mean difference of -25 mg between dexketoprofen and placebo and -23 mg between ketoprofen and placebo. These differences were statistically significant: P £ 0.0003; 95% CI -35, -14. Painintensity scores were consistently lower with the active compounds, the lowest corresponded to the dexketoprofen-treated patients. Regarding sedation, there were statistically significant differences between the two active compounds and placebo only at the 2nd and 13th hours. Wound bleeding was specifically measured with no statistically significant differences found between all the groups. Conclusions Intramuscular administration of dexketoprofen trometamol 50 mg has good analgesic efficacy both in terms of opioid-sparing effect and control of pain after major orthopaedic surgery.

Comparison of Clinical Effects of Dexketoprofen and Paracetamol used for Analgesia in Endoscopic Retrograde Cholangiopancreatography

“…Deksketoprofen ile kanama riski (trombosit agregasyonu ve kanama zamanı uzaması) diğer NSAI'lere göre daha az gö-rülmüş veya hiç görülmemiş, deksketoprofenin güvenli bir profile sahip olduğu belirtilmiştir (22)(23)(24).…”

Evaluation of preemptive dexketoprofen trometamol effect on blood chemistry, vital signs and postoperative pain in dogs undergoing ovariohysterectomy

“…The main enantiomer, dexketoprofen [S(+)-ketoprofen], is responsible for its analgesic effect while causing fewer adverse effects than racemic ketoprofen (6,13,17). In human practice, dexketoprofen is used for postoperative analgesia by the oral (18), intramuscular (19,20) or intravenous routes (21,22). The addition of trometamol to dexketoprofen increases the absorption rate after oral administration achieving maximum plasma concentration sooner than ketoprofen and dexketoprofen.…”

Treatment of Patient Syndrome at the Ambulatory-Polyclinic Stage. Selection of the Analgetic From the Positions of Comorbidity and Drug Safety: In Focus Dexketoprofen

“…Результаты многочисленных зарубежных [32][33][34][35][36][37][38][39][40][41][42][43][44] и отечественных [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] исследований позволяют рассма-тривать НПВП декскетопрофен в числе препаратов воз-можного выбора в группе ненаркотических анальгетиков на амбулаторно-поликлиническом этапе оказания меди-цинской помощи.…”

“…В течение длительного времени декскетопрофен успешно используется не только при стационарном, но и на амбулаторно-поликлиническом этапе лечения паци-ентов, в ортопедии и травматологии [34,37,38,47,48,55,[75][76][77], гинекологии [33,54,[78][79][80][81], общей хирургии [41,42,52,55,82,83], нейрохирургии [39,[84][85][86] и других отраслях медицины [5,56,60].…”