Postoperative analgesia with the use of nefopam and ketoprofen in cardiosurgical patients


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Abstract

The study was conducted in order to test effectiveness and safety of different schemes of postoperative analgesia in 135 patient undergone myocardium revascularization surgery and acquired heart defect corrections. Six combinations of postoperative analgesia were studied. The effectiveness and safety were approved for all of 6 postoperative analgesia schemes in cardiosurgical patients. The frequency of nausea, vomiting, dizziness and weakness was significantly higher in the group of PCA with Trimeperidine as monotherapy than in other groups. Combination of Nefopam and Ketoprofen provided the most expressed analgesic effect. Administration of Nefopam and Ketoprofen before extubation reduced the intensity of pain (in average for 50%) and promoted the early stirring up of patients. Combined administration of Nefopam and Ketoprofen provided opioid-saving effect for 79%, while 55% of patients don't need additional opioid analgesic administration.

About the authors

A. A Eremenko

FSBI “Boris Petrovsky National Research Center for Surgery" RAMS

119991, Moscow

L. S Sorokina

FSBI “Boris Petrovsky National Research Center for Surgery" RAMS

119991, Moscow

References

  1. Apfelbaum J.L., Chen C., Mehta S.S., Gan T.J. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97: 534-40.
  2. Dahl J.L., Gordon D., Ward S., Skemp M., Wochos S., Schurr M. Institutionalizing pain management: The postoperative pain management quality improvement project. J Pain 2003; 4: 361-371.
  3. Ranucci M., Cazzaniga A., Soro G. et al. Postoperative analgesia for early extubation after cardiac surgery: a prospective, randomized trial. Minerva Anestesiol. 1999; 65: 859-865.
  4. Mangano D.T., Siliciano D., Hollenberg M. et al. Postoperative myocardial ischemia. Therapeutic trials using intensive analgesia following surgery. The Study of Perioperative Ischemia (SPI) Research Group. Anesthesiology. 1992; 76: 342-353.
  5. Smith R.C., Leung J.M., Mangano D.T. Postoperative myocardial ischemia in patients undergoing coronary artery bypass graft surgery. S. P. I. Research Group. Anesthesiology. 1991; 464-473.
  6. Dolin S.J., Cashman J.N., Bland J.M. Effectiveness of acute postoperative pain management: I. Evidence from published data. Br J Anaesth. 2002; 89: 409-423.
  7. Еременко А.А., Урбанов А.В. Обезболивание при помощи трансдермальной терапевтической системы бупренорфина после кардиохирургических операций. Здравоохранение и медицинская техника. 2006; 28 (4): 4-7.
  8. Cashman J.N., Dolin S.J. Respiratory and haemodynamic effects of acute postoperative pain management: evidence from published data. Br J Anaesth. 2004; 93: 212-223
  9. Pettersson P.H., Jakobsson J., Owall A. Intravenous Acetaminophen reduced the use of opioids compared with oral administration after coronary artery bypass grafting. Journal of Cardiothoracic and Vascular Anesthesia. 2005; 19 (3): 306-309.
  10. Овечкин А.М. Послеоперационный болевой синдром: клинико-патофизиологическое значение и перспективные направления терапии. Consilium-medicum. Хирургия. 2005; 7 (6).
  11. Elia et al. Does multimodal analgesia with acetaminophen, nonsteroidal antiinflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone. Anesthesiology. 2005;103:1296-1304.
  12. Zippel H., Wagenitz A. Comparison of the efficacy and safety of intravenously administered dexketoprofen trometamol and ketoprofen in the management of pain after orthopaedic surgery: A multicentre, double-blind, randomised, parallel-group clinical trial. Clin Drug Investig. 2006; 26 (9): 517-528.
  13. Лебедева Р.Н., Никода В.В. Фармакотерапия острой боли. М.: Аир-Арт; 1998.
  14. Tirault M. et al. The effect of nefopam on morphin overconsumption induced by large-dose re-mifentanil during propofol anaesthesia for major abdominal surgery. Anaesth Analg. 2006; 102: 110-117.
  15. Delage H., Maaliki H., Beloeil H. Median Effective Dose (ED50) of Nefopam and Ketoprofen in Postoperative Patients. Anesthesiology. 2005; 102:1211-1216.
  16. Mimoz O., Imcagnoli P., Gillon M.C., Kuhlman L. Analgesic efficacy and safety of nefopam versus propacetamol after hepatic resection. Anaesthesia. 2001; 56: 520-525
  17. Arcioni R., et al. Ondansetron inhibits the analgesic effects of tramadol: a possible 5-HT (3) spinal receptor involvement in acute pain in humans. Anesth Analg 2002; 94: 1553-1557.

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