title: Comparison of the postoperative analgesic effects of naproxen sodium and naproxen sodium-codeine phosphate for arthroscopic meniscus surgery.
abstract: OBJECTIVE
  Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used to control arthroscopic pain. Addition of oral effective opioid "codeine" to NSAIDs may be more effective and decrease parenteral opioid consumption in the postoperative period. The aim of this study was to compare the efficacy and side effects of naproxen sodium and a new preparation naproxen sodium-codeine phosphate when administered preemptively for arthroscopic meniscectomy.
  
  
  METHODS
  Sixty-one patients were randomized into two groups to receive either oral naproxen sodium (Group N) or naproxen sodium-codeine phosphate (Group NC) before surgery. The surgery was carried out under general anesthesia. Intravenous meperidine was initiated by patient-controlled analgesia (PCA) for all patients. The primary outcome measure was pain score at the first postoperative hour assessed by the Visual Analogue Scale (VAS). Sedation assessed by Ramsey Sedation Scale, first demand time of PCA, postoperative meperidine consumption, side effects and hemodynamic data were also recorded.
  
  
  RESULTS
  The groups were demographically comparable. Median VAS scores both at rest and on movement were significantly lower in Group NC compared with Group N, except 18(th) hour on movement (p<0.05). The median time to the first demand of PCA was shorter in Group N compared with Group NC (p<0.001). Meperidine consumption was higher in Group N compared with Group NC (p<0.001). There was no difference between groups with respect to side effects (p>0.05).
  
  
  CONCLUSIONS
  The combination of naproxen sodium-codeine phosphate provided more effective analgesia than naproxen sodium and did not increase side effects.
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey. Electronic address: caglaetike@hotmail.com.
authors.forename: Cagla
authors.initials: C
authors.lastname: Bali
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Ergenoglu
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ozmete
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey.
authors.forename: Sule
authors.initials: S
authors.lastname: Akin
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey.
authors.forename: Nesrin Bozdogan
authors.initials: NB
authors.lastname: Ozyilkan
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey.
authors.forename: Oya Yalcin
authors.initials: OY
authors.lastname: Cok
authors.affiliation: Baskent University School of Medicine, Anesthesiology and Reanimation Department, Adana, Turkey.
authors.forename: Anis
authors.initials: A
authors.lastname: Aribogan
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D001182:Arthroscopy / Q000379:methods*; D003061:Codeine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000072600:Meniscus / Q000601:surgery*; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D009288:Naproxen / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D009288:Naproxen; D008614:Meperidine; D003061:Codeine
keywords: Analgesia pós-operatória; Arthroscopy; Artroscopia; Codeine phosphate; Fosfato de codeína; Naproxen sodium; Naproxeno sódico; Postoperative analgesia