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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 2001 September;67(9):641-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Ketorolac vs tramadol in the treatment of postoperative pain during maxillofacial surgery

Zackova M., Taddei S., Calò P., Bellocchio A., Zanello M.

From the Department of Anesthesia and Intensive Care, Bellaria Hospital, Bologna *Department of Anesthesiology, University Hospital, Bologna


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Background. This ­study ­aims to ­assess the ­best post­op­er­a­tive anal­ge­sia dur­ing max­il­lo­fa­cial sur­gery by ­using ­small dos­es of ketor­o­lac or tram­a­dol or ­their asso­ci­a­tion and eval­u­ates the pres­ence of ­adverse ­effects due to ­NSAID or opi­oid use.
Methods. After ­their ­informed con­sent, 51 ­patients ASA I and II under­go­ing ­major max­il­lo­fa­cial sur­gery, ­were ran­dom­ised in ­three ­groups and the fol­low­ing pro­to­col was ­used: ­group K ­received ketor­o­lac (30 mg i.v.) at the ­time of ­skin clo­sure and repeat­ed ­after 8 hrs and 16 hrs ­from the end of the oper­a­tion. Group T ­received tram­a­dol (100 mg i.v.) in the ­same con­di­tion; and ­group KT ­received ­first tram­a­dol (100 mg i.v.) dur­ing sur­gery and ­then ketor­o­lac (30 mg) was giv­en in the admin­is­tra­tions ­that fol­lowed. Meperidine 50 mg was ­used in ­case of unsat­is­fac­to­ry anal­ge­sia. Pain was eval­u­at­ed ­using ­pain inten­sity ­scores 2, 4, 6, 12 and 24 ­hours ­from the end of the oper­a­tion. Data was ana­lysed ­using Anova and χ2 ­test.
Results. The ­groups ­were com­par­able ­with ­regard to age, ­weight, dura­tion of sur­gery. Very ­good post­op­er­a­tive anal­ge­sia was record­ed in ­three ­groups .There is no dif­fer­ence sta­tis­ti­cal­ly ­between K, T and KT ­groups in the ­pain ­scores meas­ured. Only a low num­ber of ­patients ­required opi­oids admin­is­tra­tion to ­achieve ade­quate anal­ge­sia. The ­patients ­were con­sid­ered to ­have ­achieved excel­lent anal­ge­sia in 64.8% in T ­group, in 41.2% of the K ­group and in 58.8% of the KT ­group. There ­were no cas­es of insuf­fi­cient anal­ge­sia. We did not ­find a sig­nif­i­cant dif­fer­ence con­sid­er­ing BP, HR, res­pir­a­to­ry depres­sion in the ­post-oper­a­tive peri­od. Vomiting was reg­is­tered in 41.2% of ­this T ­group vs 11.2% of the K ­group and in 35.5% of the KT ­group.
Conclusions. Ketorolac and Tramadol pro­duced com­par­able , effec­tive and low ­cost post­op­er­a­tive anal­ge­sia dur­ing max­il­lo­fa­cial sur­gery. There are ­only sta­tis­ti­cal­ly sig­nif­i­cant dif­fer­enc­es con­sid­er­ing ­side ­effects.

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