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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2000 July-August;66(7-8):549-54

language: English

A prospective, randomized comparison of dexketoprofen, ketoprofen or paracetamol for postoperative analgesia after outpatient knee arthroscopy

Berti M., Albertin A., Casati A., Palmisano S., Municino G. *, da Gama Malcher M. **, De Ponti A. **

From the Università degli Studi - Milano Dipartimento di Anestesia e Rianimazione, IRCCS H. San Raffaele - Milano (Direttore: Prof. G. Torri)
*Seconda Università degli Studi - Napoli
**Università degli Studi - Milano Clinica Ortopedica IRCCS H. San Raffaele, Milano (Direttore: Prof. L. Tessari)


Background. This pros­pec­tive, ran­dom­ized ­study was con­duct­ed to eval­u­ate the qual­ity of post­op­er­a­tive ­pain ­relief ­when ­using dex­ke­to­prof­en, keto­prof­en, or par­a­cet­a­mol ­after out­pa­tient ­knee arthros­co­py.
Methods. Without pre­med­i­ca­tion, 45 ASA phys­i­cal stat­us I-II ­patients under­go­ing elec­tive out­pa­tient ­knee arthros­co­py ­with com­bined sciat­ic-femo­ral ­nerve ­block, ­were ran­dom­ly allo­cat­ed to ­receive ­either 25 mg ­oral dex­ke­to­prof­en (n=15), 50 mg ­oral keto­prof­en (n=15), or 500 mg ­oral par­a­cet­a­mol (n=15) ­before ­block place­ment. After com­ple­tion of sur­gery the ­same ­pain med­i­ca­tion was giv­en accord­ing to stan­dard pro­to­cols, ­while 50 mg ­oral tram­a­dol ­were ­allowed as res­cue anal­ge­sic if ­required by the ­patient. After stan­dard dis­charge cri­te­ria had ­been ful­filled, ­patients ­were dis­charged ­from the day-sur­gery ­unit, ­while a tele­phone fol­low-up was per­formed the day ­after sur­gery ­using stan­dard ques­tion­naires eval­u­at­ing the qual­ity of ­pain ­relief dur­ing the ­first 24 ­hours ­after sur­gery. Total con­sump­tion of res­cue tram­a­dol, max­i­mum ­pain com­plained of ­after hos­pi­tal dis­charge, as ­well as the vis­u­al ana­logue ­scale of ­pain meas­ured at hos­pi­tal dis­charge ­were ­assessed by an inde­pen­dent ­trained observ­er.
Results. No dif­fer­enc­es in anthro­po­met­ric var­i­ables, dura­tion of sur­gi­cal pro­ce­dure, and ful­fil­ment of dis­charge cri­te­ria ­were ­observed ­between the ­three ­groups. The ­degree of ­pain meas­ured at ­rest at hos­pi­tal dis­charge was sim­i­lar in the ­three ­groups, ­while the VAS meas­ured dur­ing ­motion was high­er in ­patients receiv­ing par­a­cet­a­mol (24±2.5 mm) ­than in ­those ­patients treat­ed ­with dex­ke­to­prof­en (13±6 mm) or keto­prof­en (17±5 mm) (p=0.016). Two ­patients (one in keto­prof­en ­group and one in par­a­cet­a­mol ­group) ­required res­cue tram­a­dol ­after hos­pi­tal dis­charge; how­ev­er, no dif­fer­enc­es in max­i­mum ­pain com­plained of ­after sur­gery or ­patient accep­tance ­were ­observed ­between ­groups.
Conclusions. This pros­pec­tive, ran­dom­ized ­study dem­on­strat­ed ­that in out­pa­tients receiv­ing arthros­cop­ic ­knee sur­gery, the use of 75 mg/day dex­ke­to­prof­en was as effec­tive and ­safe as 150 mg/day rac­e­mate keto­prof­en, ­with a bet­ter ­pain ­relief dur­ing ­motion com­pared to 2 g/day par­a­cet­a­mol ­when ­patients ­were dis­charged ­from the day-sur­gery ­unit.

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