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

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    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.
    Issue Date
    2012-02-03T15:10:37Z
    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
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    Citation
    Br J Anaesth. 2002 Apr;88(4):520-6.
    Journal
    British journal of anaesthesia
    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
    ISSN
    0007-0912 (Print)
    0007-0912 (Linking)
    Collections
    Cork University Hospital

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