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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

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


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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