The efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia technique in post-laparoscopic cholecystectomy pain treatment

Abstract

SummaryObjectives: Pain treatment in laparoscopic cholecystectomy, which is performed in increasing numbers as an ambulatory procedure, is an important issue.Although laparoscopic cholecystectomy is regarded as an ambulatory procedure, patients are often hospitalized due to pain and this increases opioid consumption and side effects caused by opioids. This study aims at evaluating the efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia (PCA) in postlaparoscopic cholecystectomy pain treatment.Methods: 40 patients in ASA I-II risk groups aged between 18-65 years were enrolled in the study and were randomized using closed envelope method. In Group TD 600 mg tramadol and 100 mg dexketoprofen trometamol, in Group T 600 mg tramadol was added to 100 ml 0.9% normal saline for PCA. 8 mg lornoxicam iv was given if VAS >40 in the postoperative period.Results: There was no statistically significant difference in terms of adverse effects (hypotension, bradycardia, sedation) but in Group T 4 patients complained of nausea and 3 complained of vomiting. Opioid consumption was lower and patient satisfaction was higher in group TD. Conclusion:This study has shown that adding dexketoprofen trometamol to tramadol in patient controlled analgesia following laparoscopic cholecystectomy lowers VAS scores, increases patient satisfaction and decreases opioid consumption.

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

“…In the studies conducted for postoperative pain control in the literature, it was reported that paracetamol IV increased the analgesic effect, decreased the use of opioid and increased patient satisfaction in different surgical interventions (17). However, in our literature review, we found no studies on the use of dexketoprofen IV with the aim of analgesia in procedures with sedation (either with ERCP or interventional endoscopic procedures).…”

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

“…Bu bilgilerden yola çıkarak çalışmamızda hem preemptif amaçlı, işlem sırasında da analjezik etkisinden yararlanmak için parasetamolü işlemden 30 dakika önce IV olarak uyguladık. Literatürde postoperatif ağrı kontrolü amacıyla yapılan çalış-malarda, parasetamolün IV olarak, farklı cerrahi uygulamalarda analjezik etkiyi artırdığı, opioid kullanımını azalttığı, hasta memnuniyetini artırdığı bildirilmiştir (17). Ancak literatür taramalarımızda IV deksketoprofenin sedasyon ile yapı-lacak işlemlerde (ERCP veya girişimsel endoskopik işlemler) analjezi amacıyla kullanımına dair çalışmaya rastlamadık.…”

“…Literatürdeki çalışmalar genellikle postoperatif analjezi ve hasta memnuniyetiyle ilgiliydi (17,25). Girişimsel endoskopik işlemlerde bu konuda yapılmış bir çalışmaya rastlayamadık.…”

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

“…Различий в отношении частоты возникновения побочных эффектов (гипотензия, брадикардия, седация) в группе декскетопрофена 100 мг и контрольной группе (плацебо -0,9%-ный физиологический раствор) не отме-чено [88].…”

“…В большинстве приведенных исследований и обзорах авторы, наряду с эффективностью декскетопрофена, отмечали и безопасность его применения [37,38,44,47,74,75,82,88,89]. Во многом безопасность декскетопро-фена обусловлена наличием только активного S(+)-энантиомера кетопрофена, что позволяет исключить побочные эффекты, связанные с влиянием R(-)-энантио-мера кетопрофена [32,37].…”