No abstract

Postoperative analgesia with iv propacetamol and ketoprofen combination after disc surgery Purpose: The concept of balanced analgesia suggests that a combination of analgesic drugs may enhance analgesia and reduce side effects after surgery. This study evaluated the effect of the combination of propacetamol (Prodafalgan) and ketoprofen (Profenid) after surgery of a herniated disc of the lumbar spine. Methods: After randomization, 60 patients received: placebo (group I); 2 g propacetamol (group 2); 50 mg ketoprofen (group 3); or a combination of 2 g propacetamol and 50 mg ketoprofen (group 4). Drugs were administered every six hours for two days after surgery. The patients used morphine with patient controlled analgesia pumps (bolus I rag; lock out time I 0 rain) and were evaluated with a visual analogue scale (VAS) at rest and movement every six hours for two days. Side effects were noted. Results: The patient characteristics and surgery were identical for each of the four groups. The VAS scores throughout the study were lower in group 4 than in groups I, 2 and 3 both at rest (P < 0.05) and on movement (P < 0.0 I). The cumulative dose of morphine at 48 hr was lower in group 4 than in group I (23.4 ___ 5 mg vs 58.9 -+ 9 mg; P < 0.01) or group 2 (23.4 +_ 5 mg vs 43.4 __+ 6.6 rag; P < 0.05) and similar to that in group 3 (34.2 _+ 4.5 mg). The incidence of side effects was similar in all groups. Condu, ion: The combination of propacetamol and ketoprofen recluced pain scores both at rest and on movement. The drug combination did not reduce the morphine consumption and incidence of side effects.

Patient-administered N2O/O2 inhalation provides safe and effective analgesia, at a reasonable cost, for PLB. Its routine use could be useful for the management of patients with chronic liver disease undergoing PLB as it may enhance patients compliance with future biopsies.