The effects of preemptive dexketoprofen with two different doses of tramadol use on postoperative pain relief
1Department of Anesthesiology, Hippokrateion Hospital, Queen Sofia’s Avenue, 11527 Athens, Greece
DOI: 10.22514/sv.2021.186 Vol.17,Issue S1,September 2021 pp.41-41
Submitted: 26 August 2021 Accepted: 06 September 2021
Published: 15 September 2021
In patients with moderate to severe pain, it is difficult to obtain effective analgesia with a single drug and, therefore, analgesic drugs are commonly combined to achieve optimal control of pain as combination of analgesics are often particularly effective [1, 2].
Aim: The present study aimed to evaluate the analgesic efficacy and safety of the single dose administration of dexketoprofen 50 mg/tramadol 100 mg iv in comparison with the dexketoprofen 50 mg/tramadol 200 mg in moderate to severe acute pain after total laryngectomy.
Material and methods: 36 patients undergoing surgery for laryngeal or hypopharyngeal epidermoid carcinoma, requiring a partial or total laryngectomy, took part in this study. Informed consent was obtained from all patients. Inclusion was decided during the systematic preanesthesia consultation, when it was clear that there was no contraindication to the use of the analgesic drugs prescribed. Patients in group A received IV 50 mg dexketoprofen and tramandol 100 mg and group B received IV 50 mg dexketoprofen and tramandol 200 mg, 10 min before surgery. In the first 3 postoperative days, we evaluated the intensity of acute postoperative pain, anxiety, and pain relief with VASs. These scales consisted of horizontal lines graduated from 0 to 10, with 2 end points labeled on the front side: "no pain" to "worst pain," "no anxiety" to "maximal anxiety," and "no relief of pain" to "total relief of pain." The first evaluation was performed when the patient had just recovered from anesthesia, immediately before he was taken from the recovery room, at the time defined as hour 0 (H0). The assessments were then performed every 6 hours in the first 24 hours, and every 8 hours in the following 48 hours, that is, until the postoperative 72nd hour (H72).Patients were asked to quantify the level of pain and anxiety they were experiencing at the moment of the assessment, just before the analgesic administration. The nurses performed the assessments of heart rate (radial pulse), blood pressure and respiratory rate in the same times.
Results: Demography and baseline characteristics of different treatment groups were comparable. After awakening the patients in the group B had significantly (P < 0.05) less pain [median VAS 2,5 compared to the group Α 4,1]. A 30% reduction of fentanyl requirement was seen in the group B [median 0.1 (range 0–0.3) mg] compared to the group A [0.15 (0.05–0.35) mg] in the postanaesthesia care unit (P < 0.05). Nausea and vomiting were observed more in Group B than Group A, and patient satisfaction was better in Group A (P < 0.05).
Conclusions: After laryngeal surgery for cancer, pain can reach high levels, particularly in the first hours following recovery. Dexketoprofen 50 mg combined with tramadol 200 mg provided good analgesia in postanaesthesia care unit with long duration in a model of moderate to severe pain.
Artemisia Papadima,Katerina Christodoulou,Natalia Whestzaan,Panagiotis Kekelos,Aggeliki Grigoraki,Eirini Athanasiadou,Eirini Kouroukli. The effects of preemptive dexketoprofen with two different doses of tramadol use on postoperative pain relief. Signa Vitae. 2021. 17(S1);41-41.
 Raffa RB, Tallarida RJ, Taylor R Jr, Pergolizzi JV Jr,,et al. Fixed-dose combinations for emerging treatment of pain. Expert Opin Pharmacother, 2012; 13: 1261 –1270.
 Moore RA, Derry CJ, Derry S, Straube S, McQuay H. A conservative method of testing whether combination analgesics produce additive or synergistic effects using evidence from acute pain and migraine. Eur J Pain, 2012; 16: 585 – 591.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.