Propacetamol and ketoprofen after thyroidectomy.
OBJECTIVE
The combination of non-opioid analgesic drugs, though widely used, has been rarely evaluated. The aim of this study was to compare the efficacy of propacetamol and the non-steroidal analgesic drug ketoprofen, alone or in combination, on pain relief after thyroid surgery performed using remifentanil.


METHODS
Ninety-seven patients were randomly allocated to one of the three groups: propacetamol 2 g (32), ketoprofen 100 mg (33) and propacetamol 2 g + ketoprofen 100 mg (32). Each regimen was administered intravenously (i.v.) 30 min before the end of surgery and then every 6 h. If pain was not relieved, patients received an i.v. bolus of tramadol 100 mg. Tramadol consumption and pain intensity using a visual analogue scale was recorded at 1, 2, 8 and 14 h after the end of surgery.


RESULTS
Pain scores were significantly higher with propacetamol compared with ketoprofen 2 h after surgery (35 +/- 3.7, 21 +/- 2.6, respectively; P < 0.01). The number of patients receiving tramadol was higher with propacetamol alone compared with the two other groups, 1 h (14/32, 4/33, 2/32, respectively; P > 0.01) and 2 h (24/32, 6/33, 8/32, respectively; P < 0.01) after surgery. There was no difference between ketoprofen alone and ketoprofen plus propacetamol, and there was no difference between the three groups from the 8th hour onward.


CONCLUSIONS
In the immediate postoperative period after thyroid surgery performed using remifentanil, the concomitant use of propacetamol and ketoprofen does not improve analgesia compared with ketoprofen alone.
Fourcade
O
O
University of Toulouse, Purpan Hospital, Anaesthesia Department, France. fourcade.o@chu-toulouse.fr
Sanchez
P
P
Kern
D
D
Mazoit
J X
JX
Minville
V
V
Samii
K
K
D000082:Acetaminophen / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000704:Analysis of Variance; D000768:Anesthesia, General / Q000379:methods*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D010880:Piperidines; D000077208:Remifentanil; D013965:Thyroidectomy / Q000009:adverse effects; D013997:Time Factors; D014147:Tramadol; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010880:Piperidines; D000082:Acetaminophen; D014147:Tramadol; C063776:propacetamol; D007660:Ketoprofen; D000077208:Remifentanil