Regular interval preventive pain relief compared with on demand treatment after hysterectomy.
Eighty otherwise healthy women, aged 22-64 years, admitted for elective hysterectomy were studied in a prospective randomized trial. The aim was to compare two different postoperative pain relief schedules--one with the analgesic given at regular intervals and the other with the analgesic given on demand. All the patients had a neuroleptanaesthesia with fentanyl. Forty patients received an initial dose of buprenorphine 0.3 mg intravenously before termination of anaesthesia and continued with sublingual buprenorphine 0.4 mg 6 hourly postoperatively (regular interval (RI) group). Forty patients received the standard postoperative medication, meperidine 1 mg/kg on demand in the recovery room, followed by ketobemidone 5 mg subcutaneously on demand in the surgical ward (on demand (OD) group). There was no difference between groups concerning pain relief following a single dose of analgesic (P greater than 0.05, type II error 1-5%). In the recovery room 17.5% of the patients in the RI group received an analgesic compared to 87.5% in the OD group (P less than 0.05). Among patients in the RI group who had previously got injections for postoperative pain relief on demand 95% preferred regular interval sublingual buprenorphine for future treatment. The nurses found that 90% of the patients in the RI group were treated adequately compared to 62.5% of the patients in the OD group (P less than 0.05). It is concluded, that regular interval preventive pain relief is superior to conventional on demand analgesic therapy in postoperative pain.
Jørgensen
Bent Chræmmer
BC
Department of Anaesthesia, University of Copenhagen, Glostrup Hospital, DK-2600 GlostrupDenmark.
Schmidt
Jes F
JF
Risbo
Allan
A
Pedersen
Jan
J
Kolby
Peter
P
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008614:Meperidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D009019:Morphinans / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*
D000701:Analgesics, Opioid; D009019:Morphinans; D002047:Buprenorphine; D008614:Meperidine; C012394:ketobemidone