title: A comparison of intravenous ketoprofen versus pethidine on peri-operative analgesia and post-operative nausea and vomiting in paediatric vitreoretinal surgery.
abstract: OBJECTIVE
  To compare the efficacy of ketoprofen and pethidine for peri-operative analgesia and post-operative nausea and vomiting in children undergoing vitreoretinal surgery and surgery for retinal detachment.
  
  
  METHODS
  Children aged 7 to 16 years and ASA I status, undergoing vitreo-retinal surgery were randomly allocated to receive either ketoprofen 2mg/kg or pethidine 1mg/kg intravenously for peri-operative analgesia. In all patients, general anaesthesia was induced with thiopentone and intubation was facilitated with vecuronium bromide and maintained with 33% oxygen in nitrous oxide and isoflurane. Intra-operative and post-operative monitoring was done by an observer blinded to the technique. Intra-operative rescue analgesia was used if heart rate and/or blood pressure increased by 25% from pre-incision values. Post-operative pain and episodes of nausea and vomiting were evaluated at recovery (0 hour), 2, 6 and 24 hours intervals. Standard rescue analgesia and anti-emetic agents were administered if required.
  
  
  RESULTS
  Eighty-six children were enrolled in the study. Forty-four received ketoprofen while 42 received pethidine. Intra-operative analgesia was comparable in both the groups and no significant difference was found in the requirement of intra-operative rescue analgesia, as well. Postoperatively 6/44 (13.6%) children in ketoprofen group had pain at recovery compared to 17/42 (40.4%) in pethidine group. Pain at 2, 6 and 24 hours, and postoperative analgesic requirement were not significantly different among the two groups. Post-operative nausea, vomiting, and antiemetic requirement were significantly less in the ketoprofen group at all time intervals.
  
  
  CONCLUSIONS
  Ketoprofen is a satisfactory alternative analgesic to pethidine for vitreoretinal surgery and results in a lower incidence of postoperative nausea and vomiting.
authors.affiliation: Department of Anaesthesiology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India. ghaibabita@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Subramaniam
authors.forename: B
authors.initials: B
authors.lastname: Ghai
authors.forename: M
authors.initials: M
authors.lastname: Khetarpal
authors.forename: M S
authors.initials: MS
authors.lastname: Subramanyam
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007660:Ketoprofen / Q000008:administration & dosage* / Q000627:therapeutic use*; D008297:Male; D008614:Meperidine / Q000008:administration & dosage* / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D012163:Retinal Detachment / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007660:Ketoprofen; D008614:Meperidine