.: ORİJİNAL ARAŞTIRMA
Comparison of the Postoperative Analgesic Effectiveness and Side Effects of Intravenous Dexketoprofen Trometamol and Ibuprofen in Patients Undergoing Abdominal Hysterectomy: A Randomized, Double-Blind, Placebo-Controlled, Prospective Study
Abdominal Histerektomi Uygulanan Hastalarda İntravenöz Deksketoprofen Trometamol ve İbuprofenin Postoperatif Analjezik Etkinliğinin ve Yan Etkilerinin Karşılaştırılması: Randomize, Çift Kör, Plasebo Kontrollü Prospektif Çalışma
Turkiye Klinikleri J Anest Reanim. 2025;23(2):35-42
doi: 10.5336/anesthe.2024-104326
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Postoperative pain prolongs recovery and hospital stay if not treated effectively. We aimed to compare the postoperative analgesic efficacy and side effects of intravenous dexketoprofen trometamol and ibuprofen in patients undergoing abdominal hysterectomy. Material and Methods: 90 patients aged 18-65 years, American Society of Anesthesiologists I-II, undergoing abdominal hysterectomy were randomly divided into 3 equal groups. At the transition to surgical closure, patients in ibuprofen group (Group I) received 400 mg of ibuprofen, patients in dexketoprofen group (Group D) received 50 mg of dexketoprofen (trometamol), and the patients in placebo group (Group P) received 100 ml of saline as infusion over 30 minutes. Patient controlled analgesia prepared with morphine was started in the postoperative period. Hemodynamic parameters, Visual Analogue Scale (VAS) scores, morphine consumption and possible side effects were recorded at postoperative 0, 10, 30 minutes and 1, 2, 6, 12, 24 hours. Results: Morphine comsumption, was observed as lower in Group I and Group D from the postoperative 6th hour compared to Group P, and in Group I it was decreased compared to Group D from the postoperative 6th hour (p<0.005). VAS scores, was found decreased in all measurements in Group I and in all measurements in Group D except the 6th hour compared to the placebo group (p<0.05). Conclusion: We concluded that both drugs reduce morphine consumption in the treatment of postoperative pain in abdominal hysterectomies, ibuprofen provides more effective postoperative analgesia than dexketoprofen (trometamol), and both drugs can be used safely in multimodal analgesia.
Keywords: Postoperative analgesia; dexketoprofen trometamol; ibuprofen; morphine
Objective: Postoperative pain prolongs recovery and hospital stay if not treated effectively. We aimed to compare the postoperative analgesic efficacy and side effects of intravenous dexketoprofen trometamol and ibuprofen in patients undergoing abdominal hysterectomy. Material and Methods: 90 patients aged 18-65 years, American Society of Anesthesiologists I-II, undergoing abdominal hysterectomy were randomly divided into 3 equal groups. At the transition to surgical closure, patients in ibuprofen group (Group I) received 400 mg of ibuprofen, patients in dexketoprofen group (Group D) received 50 mg of dexketoprofen (trometamol), and the patients in placebo group (Group P) received 100 ml of saline as infusion over 30 minutes. Patient controlled analgesia prepared with morphine was started in the postoperative period. Hemodynamic parameters, Visual Analogue Scale (VAS) scores, morphine consumption and possible side effects were recorded at postoperative 0, 10, 30 minutes and 1, 2, 6, 12, 24 hours. Results: Morphine comsumption, was observed as lower in Group I and Group D from the postoperative 6th hour compared to Group P, and in Group I it was decreased compared to Group D from the postoperative 6th hour (p<0.005). VAS scores, was found decreased in all measurements in Group I and in all measurements in Group D except the 6th hour compared to the placebo group (p<0.05). Conclusion: We concluded that both drugs reduce morphine consumption in the treatment of postoperative pain in abdominal hysterectomies, ibuprofen provides more effective postoperative analgesia than dexketoprofen (trometamol), and both drugs can be used safely in multimodal analgesia.
Keywords: Postoperative analgesia; dexketoprofen trometamol; ibuprofen; morphine
ÖZET
Amaç: Postoperatif ağrı etkin şekilde tedavi edilmediği takdirde iyileşme ve hastanede yatış süresini uzatmaktadır. Abdominal histerektomi uygulanacak olan hastalarda intravenöz deksketoprofen (trometamol) ve ibuprofenin, postoperatif analjezik etkinliğini ve yan etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Abdominal histerektomi uygulanacak 18-65 yaş arası, Amerikan Anestezistler Derneği I-II, 90 hasta randomize olarak 3 eşit gruba ayrıldı. Cerrahi kapamaya geçildiğinde; ibuprofen grubundaki (Grup I) hastalara 400 mg ibuprofen, deksketoprofen grubundaki (Grup D) hastalara 50 mg deksketoprofen (trometamol) ve plasebo grubundaki (Grup P) hastalara 100 ml serum fizyolojik, 30 dk'da infüzyon şeklinde uygulandı. Postoperatif dönemde tüm hastalara morfin ile hazırlanan hasta kontrollü analjezi başlandı. Hemodinamik parametreler, Görsel Analog Skala [Visual Analogue Scale (VAS)] değerleri, morfin tüketimi ve olası yan etkiler postoperatif 0, 10, 30. Dakikalarda ve 1, 2, 6, 12, 24. saatlerde kaydedildi. Bulgular: Morfin tüketiminin; Grup I ve Grup D'de postoperatif 6. saatten itibaren Grup P'ye göre düşük olduğu, Grup I'de ise postoperatif 6. saatten itibaren Grup D'ye göre azaldığı gözlendi (p<0,05). VAS değerlerinin; Grup I'de tüm ölçümlerde, Grup D'de ise 6. Saat hariç tüm ölçümlerde plasebo grubuna göre azaldığı, diğer tüm ölçümlerde Grup I'de düşük olduğu bulundu (p<0,05). Sonuç: Abdominal histerektomilerde postoperatif ağrı tedavisinde her iki ilacın da morfin tüketimini azalttığı, ibuprofenin deksketoprofen trometamole göre daha etkin bir postoperatif analjezi sağladığı ve her iki ilacın da multimodal analjezide güvenle kullanılabileceği sonucuna varılmıştır.
Anahtar Kelimeler: Postoperatif analjezi; deksketoprofen (trometamol); ibuprofen; morfin
Amaç: Postoperatif ağrı etkin şekilde tedavi edilmediği takdirde iyileşme ve hastanede yatış süresini uzatmaktadır. Abdominal histerektomi uygulanacak olan hastalarda intravenöz deksketoprofen (trometamol) ve ibuprofenin, postoperatif analjezik etkinliğini ve yan etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Abdominal histerektomi uygulanacak 18-65 yaş arası, Amerikan Anestezistler Derneği I-II, 90 hasta randomize olarak 3 eşit gruba ayrıldı. Cerrahi kapamaya geçildiğinde; ibuprofen grubundaki (Grup I) hastalara 400 mg ibuprofen, deksketoprofen grubundaki (Grup D) hastalara 50 mg deksketoprofen (trometamol) ve plasebo grubundaki (Grup P) hastalara 100 ml serum fizyolojik, 30 dk'da infüzyon şeklinde uygulandı. Postoperatif dönemde tüm hastalara morfin ile hazırlanan hasta kontrollü analjezi başlandı. Hemodinamik parametreler, Görsel Analog Skala [Visual Analogue Scale (VAS)] değerleri, morfin tüketimi ve olası yan etkiler postoperatif 0, 10, 30. Dakikalarda ve 1, 2, 6, 12, 24. saatlerde kaydedildi. Bulgular: Morfin tüketiminin; Grup I ve Grup D'de postoperatif 6. saatten itibaren Grup P'ye göre düşük olduğu, Grup I'de ise postoperatif 6. saatten itibaren Grup D'ye göre azaldığı gözlendi (p<0,05). VAS değerlerinin; Grup I'de tüm ölçümlerde, Grup D'de ise 6. Saat hariç tüm ölçümlerde plasebo grubuna göre azaldığı, diğer tüm ölçümlerde Grup I'de düşük olduğu bulundu (p<0,05). Sonuç: Abdominal histerektomilerde postoperatif ağrı tedavisinde her iki ilacın da morfin tüketimini azalttığı, ibuprofenin deksketoprofen trometamole göre daha etkin bir postoperatif analjezi sağladığı ve her iki ilacın da multimodal analjezide güvenle kullanılabileceği sonucuna varılmıştır.
Anahtar Kelimeler: Postoperatif analjezi; deksketoprofen (trometamol); ibuprofen; morfin
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