Efficacy of Intravenous Paracetamol and Dexketoprofen on Postoperative Pain and Morphine Consumption After a Lumbar Disk Surgery

Tunalı, Yusuf; Akçıl, Eren Fatma; Dilmen, Özlem Korkmaz; Tütüncü, Ayşe Çiğdem; Köksal, Güniz Meyancı; Akbaş, Sedat; Vehid, Hayriye Ertem; Yentür, Ercüment

doi:10.1097/ana.0b013e31827464af

Cited by 42 publications

(48 citation statements)

References 16 publications

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“…Paracetamol stands out among nonopioid analgesics due its effective analgesia and reduced side effect profile. However, many recent studies have reported adverse effects of paracetamol on postoperative pain and morphine consumption after surgery (15)(16)(17)(18). Tunali et al compared the postoperative analgesic effect of paracetamol and dexketoprofen and reported that dexketoprofen provides better analgesia (15).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Yılmaz¹,

Sarihasan²,

Kelsaka³

et al. 2015

Turk J Med Sci

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IntroductionDespite developments in the pathophysiology and treatment of pain, increased knowledge of pain management, the availability of new drugs, and complex drug delivery systems, the pain management of many patients after surgery remains inadequate. Studies have shown that successful postoperative analgesia after surgery prevents many side effects of pain, such as the inability to breathe at ease, the increase in the workload of the cardiovascular system, the development of thromboembolic events due to a delay in the mobilization of patient, and the increase in stress response due to the activation of the sympathetic nervous and neuroendocrine systems (1,2). Inadequate treatment of acute pain is the most common cause of chronic pain after surgery. The aim after surgery is to ensure that organ functioning returns to normal quickly by controlling pain as soon as possible (3).Today it is possible to achieve successful postoperative analgesia by selecting appropriate methods/routes of administration, agents, dosages, and dosage ranges. Opioids are the most widely used group of drugs in the treatment of postoperative pain due to their strong analgesic activities. However, opioid-related nausea, vomiting, pruritus, urinary retention, respiratory depression, sedation, and central nervous system depression have accelerated the search for analgesic drugs with better pain relief efficacy and fewer side effects (4).Research has reported gastric irritation, erosion, bleeding, and inhibition of platelet aggregation with nonsteroidal antiinflammatory drugs (NSAIDs), in addition to adverse effects on the secretion of uric acid and bleeding (5), thereby restricting their use. Side effects, such as systemic toxicity and prolonged sensory and motor responses, have also been reported with local anesthetic drugs used to provide pain control (6). Tramadol, a weak, effective synthetic opioid, has been shown to have relatively few side effects compared to other opioids, and its abuse or addiction potential is negligible (7). Paracetamol is a Background/aim: To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery. Materials and methods: Group P (paracetamol group) was given 1 g of paracetamol intravenously 30 min before the end of the operation and 1 g each day at 6-h intervals. Group T (tramadol group) was given 1.5 mg/kg of tramadol as a loading dose and patient-controlled analgesia for 1 day. Hemodynamic parameters, modified Aldrete score, Ramsay sedation scale score, patient satisfaction scale (PSS) score, visual analog scale (VAS) score, nausea/vomiting scale score, and additional analgesic needs/times were recorded.Results: PSS scores were significantly higher in Group T (P < 0.05). The total analgesic consumption was significantly higher in Group P. There were no significant differences in the VAS scores at any time points. Twenty-one patients in Group P and 8 patients in Group T needed additional analgesia (P < 0.05). The first additional analg...

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Section: Discussionmentioning

confidence: 99%

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Yılmaz¹,

Sarihasan²,

Kelsaka³

et al. 2015

Turk J Med Sci

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show abstract

“…The 2 RCTs that tested tramadol found that it did not reduce pain scores but it was more effective than placebo and less effective than fentanyl in reducing opioid consumption . The 2 RCTs that tested paracetamol found that it was more effective than placebo and less effective than dexketoprofen in reducing pain scores . The RCTs that tested systemic lidocaine, ketorolac, and NSAIDs (tenoxicam) led to controversial results .…”

Section: Resultsmentioning

confidence: 99%

Prevention and Treatment of Postoperative Pain after Lumbar Spine Procedures: A Systematic Review

et al. 2018

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Clinical evidence on perioperative pain management in patients undergoing spine procedures have significantly evolved after the review published in 2012. The aim of this systematic review was to report the latest evidence published. These include the preoperative use of dexamethasone, which was shown to be able to reduce pain at mobilization but not to reduce pain at rest or total morphine consumption; the use of gabapentinoids as part of a multimodal analgesic approach; and the safety and effectiveness of the intraoperative use of ketamine, dexketoprofen, and tramadol. Finally, electrical nerve stimulation is gaining interest and is potentially suitable for clinical needs.

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“…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].…”

Section: неврологияunclassified

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

Трухан¹,

Иванова²

2017

Med. sov.

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Efficacy of Intravenous Paracetamol and Dexketoprofen on Postoperative Pain and Morphine Consumption After a Lumbar Disk Surgery

Abstract: The study showed that pain intensity during 24 hours after the lumbar disk surgery was significantly lowered by dexketoprofen, but not with paracetamol, as a supplemental analgesic to morphine patient-controlled analgesia when compared with controls.

Cited by 42 publications

References 16 publications

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Prevention and Treatment of Postoperative Pain after Lumbar Spine Procedures: A Systematic Review

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

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