Effect of perioperative administration of dexketoprofen on opioid requirements and inflammatory response following elective hip arthroplasty.

Hdl Handle:
http://hdl.handle.net/10147/209039
Title:
Effect of perioperative administration of dexketoprofen on opioid requirements and inflammatory response following elective hip arthroplasty.
Authors:
Iohom, G; Walsh, M; Higgins, G; Shorten, G
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and National University of Ireland, Republic of Ireland.
Citation:
Br J Anaesth. 2002 Apr;88(4):520-6.
Journal:
British journal of anaesthesia
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209039
PubMed ID:
12066728
Abstract:
BACKGROUND: In this double-blind, randomized, placebo-controlled trial, the safety and analgesic efficacy of perioperative dexketoprofen were evaluated. METHODS: Thirty ASA I or II patients undergoing elective hip arthroplasty were randomized to one of two groups. One group (D) received dexketoprofen 25 mg tds for 24 h before and 48 h after surgery; the second group (P) received placebo tablets at equivalent times. Hyperbaric 0.5% bupivacaine (17.5 mg if greater than 70 kg and 15 mg if less than 70 kg) and preservative-free morphine (0.6 mg) were administered intrathecally. Postoperatively, PCA was provided (bolus morphine sulphate 1 mg; lockout 5 min; no continuous infusion). RESULTS: The two groups were similar in terms of age, gender, weight, height, ASA class, duration of operation, and level of sensory block on arrival to the recovery room. Groups were also similar in terms of blood loss, transfusion requirements, ventilatory frequency, and haemodynamic variables. According to visual analogue pain scores patients in group D experienced less pain at 15 h (P=0.02) postoperatively. Cumulative morphine consumption was also less in group D compared with group P at 6 (0.06 (0.2) vs 0.85 (1.4) mg, P=0.04) and 48 h postoperatively (10.1 (8) vs 26.2 (20) mg, P<0.01). Plasma interleukin 6 concentrations increased postoperatively to a significantly lesser extent in group D than in group P (P=0.02). Nausea and vomiting were less (P<0.01) in group D compared with group P at 18 h postoperatively. Sedation scores were less (P=0.03) in group D. CONCLUSIONS: Perioperative administration of dexketoprofen 25 mg 8 hourly markedly improves analgesia and decreases opioid requirements (and associated adverse effects) following hip arthroplasty. It appears that this regimen decreases the postoperative pro-inflammatory response.
Language:
eng
MeSH:
Aged; Analgesics, Opioid/*administration & dosage; Anesthesia, Spinal; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use; *Arthroplasty, Replacement, Hip; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Female; Hemodynamics/drug effects; Humans; Inflammation/*prevention & control; Ketoprofen/*analogs & derivatives/*therapeutic use; Male; Middle Aged; Pain, Postoperative/*prevention & control; Perioperative Care/methods; Prospective Studies; Tromethamine/*analogs & derivatives/*therapeutic use
ISSN:
0007-0912 (Print); 0007-0912 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorIohom, Gen_GB
dc.contributor.authorWalsh, Men_GB
dc.contributor.authorHiggins, Gen_GB
dc.contributor.authorShorten, Gen_GB
dc.date.accessioned2012-02-03T15:10:37Z-
dc.date.available2012-02-03T15:10:37Z-
dc.date.issued2012-02-03T15:10:37Z-
dc.identifier.citationBr J Anaesth. 2002 Apr;88(4):520-6.en_GB
dc.identifier.issn0007-0912 (Print)en_GB
dc.identifier.issn0007-0912 (Linking)en_GB
dc.identifier.pmid12066728en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209039-
dc.description.abstractBACKGROUND: In this double-blind, randomized, placebo-controlled trial, the safety and analgesic efficacy of perioperative dexketoprofen were evaluated. METHODS: Thirty ASA I or II patients undergoing elective hip arthroplasty were randomized to one of two groups. One group (D) received dexketoprofen 25 mg tds for 24 h before and 48 h after surgery; the second group (P) received placebo tablets at equivalent times. Hyperbaric 0.5% bupivacaine (17.5 mg if greater than 70 kg and 15 mg if less than 70 kg) and preservative-free morphine (0.6 mg) were administered intrathecally. Postoperatively, PCA was provided (bolus morphine sulphate 1 mg; lockout 5 min; no continuous infusion). RESULTS: The two groups were similar in terms of age, gender, weight, height, ASA class, duration of operation, and level of sensory block on arrival to the recovery room. Groups were also similar in terms of blood loss, transfusion requirements, ventilatory frequency, and haemodynamic variables. According to visual analogue pain scores patients in group D experienced less pain at 15 h (P=0.02) postoperatively. Cumulative morphine consumption was also less in group D compared with group P at 6 (0.06 (0.2) vs 0.85 (1.4) mg, P=0.04) and 48 h postoperatively (10.1 (8) vs 26.2 (20) mg, P<0.01). Plasma interleukin 6 concentrations increased postoperatively to a significantly lesser extent in group D than in group P (P=0.02). Nausea and vomiting were less (P<0.01) in group D compared with group P at 18 h postoperatively. Sedation scores were less (P=0.03) in group D. CONCLUSIONS: Perioperative administration of dexketoprofen 25 mg 8 hourly markedly improves analgesia and decreases opioid requirements (and associated adverse effects) following hip arthroplasty. It appears that this regimen decreases the postoperative pro-inflammatory response.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAnalgesics, Opioid/*administration & dosageen_GB
dc.subject.meshAnesthesia, Spinalen_GB
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal/*therapeutic useen_GB
dc.subject.mesh*Arthroplasty, Replacement, Hipen_GB
dc.subject.meshDouble-Blind Methoden_GB
dc.subject.meshDrug Administration Scheduleen_GB
dc.subject.meshDrug Therapy, Combinationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHemodynamics/drug effectsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInflammation/*prevention & controlen_GB
dc.subject.meshKetoprofen/*analogs & derivatives/*therapeutic useen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPain, Postoperative/*prevention & controlen_GB
dc.subject.meshPerioperative Care/methodsen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshTromethamine/*analogs & derivatives/*therapeutic useen_GB
dc.titleEffect of perioperative administration of dexketoprofen on opioid requirements and inflammatory response following elective hip arthroplasty.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and National University of Ireland, Republic of Ireland.en_GB
dc.identifier.journalBritish journal of anaesthesiaen_GB
dc.description.provinceMunster-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.