Efficacy of Non-Opioid Analgesics on Opioid Consumption for Postoperative Pain Relief After Abdominal Hysterectomy

Abstract

Objective: The purpose of this study was to compare the analgesic efficacy and pain intensity of and patient's satisfaction with non-opioid analgesics while evaluating postoperative piritramide consumption for providing pain relief after abdominal hysterectomy. Design: This was a randomized, double-blinded study. Materials and Methods: With the patient under general anesthesia, surgery was performed on 120 women using propofol, remifentanil, and muscle relaxant. Four patient groups (n = 30 each) were treated over 24 hours with normal saline (NaCl), parecoxib, metamizol, or paracetamol in addition to piritramide using the patient-controlled analgesia (PCA) pump. Postoperatively, patients were asked every 2 hours for the first 6 hours, and afterwards once every 6 hours, to quantify their pain experience at rest on different pain scales, including patient satisfaction. Cumulative piritramide consumption within 24 hours postoperatively was recorded on the display of the PCA pump. Results: The first required amounts of piritramide in the recovery room were similarly high in all groups and the incremental piritramide consumptions after 6, 12 and 24 hours showed no significant difference among the four groups. Also, with cumulative PCA-piritramide consumption no significant difference could be found. In all groups, the highest level of the visual analogue scale (VAS) score was registered upon arrival in the recovery room. However, there was a significant difference only at 6 hours after surgery between the NaCl group and the paracetamol and parecoxib groups. Conclusions: Compared with placebo, there was no significant difference in regard to opioid-sparing effect by administering additional non-opioids, whereas VAS scores were significantly lower in the paracetamol and parecoxib groups at 6 hours after surgery. Any further benefits were marginal and statistically not significant. ( J GYNECOL SURG 28:101)

Multiple-, But Not Single-, Dose of Parecoxib Reduces Shoulder Pain after Gynecologic Laparoscopy

“…Akaraviputh et al indicated that preoperative infusion 20mg parecoxib could reduce the postoperative opioid consumption 30, and Papadima et al showed that preoperative parecoxib 40mg was efficacious for pain control and opioids sparing following laparoscopic cholecystectomy 31. In another study, parecoxib 40 mg twice daily attenuated worst pain in laparoscopic cholecystectomy32, but a latest study found that the efficacy of same medication on piritramide consumption and pain relief was weak 33. For gynecologic laparoscopies, the results of parecoxib are also contradictory 34, 35.…”

Intraperitoneal Bupivacaine Alone With Dexmedetomidine or Tramadol for Postoperative Analgesia Following Laparoscopic Cholecystectomy- A Comparative Evaluation

“…37,38,39 Multimodal efforts like parenteral opioids, non-steroidal antiinflammatory drugs or local wound infiltration have been done to reduce overall pain and benefit postoperative conditions of patients undergoing laparoscopic surgeries. [40][41][42] Despite their efficacy with all parenteral medications, there are associated adverse effects.…”

Efectividad De Anestesia De Plexo Cervical Superficial Preoperatorio Para Control De Dolor Postoperatorio en Cirugía De Tiroides

“…El tema de analgesia y tiroidectomía tiene muchos aspectos que continúan en evaluación, con medidas del tipo de analgesia preventiva buscamos elaborar un protocolo de tiroidectomía ambulatoria en el corto plazo [12][13][14][15] .…”