Guidelines on perioperative optimization protocol for the adult patient 2023

Bloc, Sébastien; Alfonsi, Pascal; Belbachir, A.; Beaussier, Marc; Bouvet, Lionel; Campard, Sébastien; Campion, Sébastien; Cazenave, Laure; Diemunsch, Pierre; Maria, Sophie Di; Dufour, Guillaume; Fabri, Simon G.; Fletcher, Dominique; Garnier, Marc; Godiér, Anne; Grillo, Philippe; Huet, Olivier; Joosten, Alexandre; Lasocki, Sigismond; Guen, Morgan Le; Saché, Frédéric Le; Macquer, Isabelle; Marquis, Constance; Montblanc, Jacques de; Maurice-Szamburski, Axel; Nguyen, Yên-Lan; Ruscio, Laura; Zieleskiewicz, Laurent; Caillard, Anaïs; Weiss, Emmanuel

doi:10.1016/j.accpm.2023.101264

Cited by 20 publications

(1 citation statement)

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“…There are some limitations such as using one dose of each drug, the lack of local anesthetic wound infiltration, and the limited duration of follow-up. In this study, we used dexamethasone in a dose of 4 mg for prophylaxis against postoperative nausea and vomiting and as an analgesic adjuvant [26]. Since the analgesic effect of dexamethasone is dose-dependent [14], future studies are needed to explore the efficacy of the two drugs in the presence of higher dose of dexamethasone (> 4 mg).…”

Section: Discussionmentioning

confidence: 99%

Intravenous ibuprofen versus ketorolac for perioperative pain control in open abdominal hysterectomy: a randomized controlled trial

Amin,

Hasanin,

Attia

et al. 2024

BMC Anesthesiol

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Background We aimed to compare the analgesic effects of intravenous ibuprofen to ketorolac after open abdominal hysterectomy. Methods This randomized double-blinded controlled trial included adult women scheduled for elective open abdominal hysterectomy. Participants were randomized to receive either 30 mg ketorolac (n = 50) or 800 mg ibuprofen (n = 50) preoperatively, then every 8 h postoperatively for 24 h. All participants received paracetamol 1 gm/6 h. Rescue analgesic was given if the visual analogue scale (VAS) for pain assessment was > 3. The primary outcome was the mean postoperative dynamic VAS during the first 24 h. Secondary outcomes were static VAS, intraoperative fentanyl consumption, postoperative morphine consumption, time to independent movement, and patient’s satisfaction. Results Forty-six patients in the ibuprofen group and fifty patients in the ketorolac group were analyzed. The 24-h dynamic and static VAS were similar in the two groups. The median (quartiles) dynamic VAS was 1.1 (0.9, 1.9) in the ibuprofen group versus 1.0 (0.7, 1.3) in the ketorolac group, P-value = 0.116; and the median (quartiles) static VAS was 0.9 (0.6, 1.3) in the ibuprofen group versus 0.7 (0.4, 1.1) in the ketorolac group, P-value = 0.113. The intra- and postoperative analgesic requirements were also similar in the two groups. However, patient satisfaction was slightly higher in the ketorolac group than that in the ibuprofen group (median [quartiles]: 6 [5, 7] versus 5 [4, 7], respectively), P-value: 0.009. Conclusion The two drugs, intravenous ibuprofen and ketorolac produced similar analgesic profile in patients undergoing open abdominal hysterectomy receiving multimodal analgesic regimen. NCT05610384, Date of registration: 09/11/2022 Clinical trial registration ClinicalTrials.gov Identifier: NCT05610384. https://clinicaltrials.gov/ct2/show/NCT05610384

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Section: Discussionmentioning

confidence: 99%