Efficacy of intravenous paracetamol and dexketoprofen on postoperative pain and morphine consumption after a lumbar disk surgery.
BACKGROUND
We compared the analgesic effects of intravenous (IV) paracetamol with that of dexketoprofen on postoperative pain and morphine consumption during the first 24 hour after a lumbar disk surgery.


METHODS
This prospective, placebo-controlled, double blind study investigated the analgesic effects of IV paracetamol and dexketoprofen on postoperative pain, morphine consumption, and morphine-related side effects after a lumbar disk surgery. Sixty American Society of Anesthesiologists 1 or 2 status patients scheduled for elective lumbar disk surgery under general anesthesia were included in the study. Patients were treated using patient-controlled analgesia with morphine for 24 hours after a lumbar disk surgery and randomized to receive IV paracetamol 1 g, dexketoprofen 50 mg, or isotonic saline (placebo). The primary endpoint was pain intensity measured by the visual analogue scale, and secondary endpoints were morphine consumption and related side effects.


RESULTS
Pain intensity was lower in the dexketoprofen group (P=0.01) but not in the paracetamol group (P=0.21) when compared with the control group. Cumulative morphine consumption and morphine-related side effects did not reveal significant differences between the groups.


CONCLUSIONS
The study showed that pain intensity during 24 hours after the lumbar disk surgery was significantly lowered by dexketoprofen, but not with paracetamol, as a supplemental analgesic to morphine patient-controlled analgesia when compared with controls.
Department of Anesthesiology and Intensive Care, Cerrahpasa Medical Faculty, Istanbul University, 34098 Istanbul, Turkey.
Yusuf
Y
Tunali
Eren F
EF
Akçil
Ozlem Korkmaz
OK
Dilmen
Ayse C
AC
Tutuncu
Guniz Meyanci
GM
Koksal
Sedat
S
Akbas
Hayriye
H
Vehid
Ercument
E
Yentur
D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007403:Intervertebral Disc / Q000601:surgery*; D007660:Ketoprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019635:Neurosurgical Procedures / Q000379:methods; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011446:Prospective Studies
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D009020:Morphine; D007660:Ketoprofen