The effect of preoperative intravenous dexketoprofen trometamol on postoperative pain in minor outpatient urologic surgery

Abstract

Objective: The aim of this prospective double-blind randomized study was to compare the effectiveness of preoperative dexketoprofen trometamol for acute postoperative pain in patients undergoing minor outpatient urologic surgery. Material and methods:Sixty male patients (ASA I and II) undergoing varicocelectomy and testicular sperm extraction (TESE) with standard laryngeal mask airway (LMA) anesthesia were randomly divided into two groups. Patients in Group I (n=30) received 50 mg of dexketoprofen trometamol iv before induction, whereas patients in Group II (n=30) received saline. All patients received standard LMA anesthesia (propofol, sevoflurane and N 2 O/O 2 ). Analgesic efficacy was evaluated by self-assessment of pain intensity (VAS) at regular intervals. Vital signs, side effects and time to reach a postanesthesia discharge score (PADS) of ≥9 were also recorded. Paracetamol 1 gr iv and tramadol 100 mg iv were used for rescue analgesia.Results: Demographic data and duration of surgery were similar in both groups. There was no significant difference between groups with respect to postoperative pain scores and side effects. Although more patients in Group II (60%) required rescue analgesia compared to Group I (33.3%), the difference did not reach statistical significance. Conclusion:Preoperative IV use of dexketoprofen trometamol iv did not decrease the need for rescue analgesia in patients undergoing minor outpatient urological surgery.

Analgesic efficacy of preoperative dexketoprofen trometamol: A systematic review and meta‐analysis

“…Eight studies reported lower opioid consumption and postoperative pain, as well as a longer time requiring a second dose of the drug, favoring preoperative administration of DEX. One study (Bolat et al, ) reported no difference in the same comparison previously described. However, this study did not report the total data of the study.…”

“…of DEX (Eroglu, Durmus, & Kiresi, ; Esparza‐Villalpando et al, ; Iohom, Walsh, Higgins, & Shorten, ; Kara, Tuncer, Erol, & Reisli, ; Kesimci, Gümüs, & Kanbak, ), while the other studies employed intravenous (i.v.) administration (Atalay, Dogan, & Kizilkaya, ; Bolat, Erhan, & Deniz, ; Çağiran, Eyigör, & Sezer, ; Gelir, ; Gülhaş et al, ; Kadıoğlu, Tüker, Gurbet, Demirci, & Hülagü, ; Kelsaka, Guldogus, & Cetinoglu, ; Sagiroglu, ; Ozer et al, ). Eight studies utilized DEX 50 mg (Atalay et al, ; Bolat et al, ; Çağiran et al, ; Gelir, ; Gülhaş et al, ; Kadıoğlu et al, ; Kelsaka et al, ; Ozer et al, ), while the remaining studies evaluated DEX 25 mg (Esparza‐Villalpando et al, ; Iohom et al, ; Kara et al, ; Kesimci et al, ; Ozer et al, ; Sagiroglu, ).…”

“…Nine articles reported this comparison (Atalay et al,; Bolat et al, ; Çağiran et al, ; Gelir, ; Gülhaş et al, ; Iohom et al, ; Kara et al, ; Kesimci et al, ; Kelsaka et al, ). Age of the patients included in these studies ranged from 18 to 85 years.…”

“…The surgical protocol and the administration routes were different between the studies. Five studies evaluated oral administration ( Nine articles reported this comparison (Atalay et al,2012;Bolat et al, 2013;Ça giran et al, 2014;Gelir, 2016;G€ ulhaş et al, 2011;Iohom et al, 2002;Kara et al, 2011;Kesimci et al, 2011;Kelsaka et al, 2014).…”