The effect of pre-emptive intravenous Dexketoprofen + thoracal epidural analgesia on the chronic post-thoracotomy pain


Comez M. S., Celik M., DOSTBİL A., AKSOY M., AHISKALIOĞLU A., Fuat Erdem A., ...Daha Fazla

International Journal of Clinical and Experimental Medicine, cilt.8, sa.5, ss.8101-8107, 2015 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 8 Sayı: 5
  • Basım Tarihi: 2015
  • Dergi Adı: International Journal of Clinical and Experimental Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.8101-8107
  • Anahtar Kelimeler: Dexketoprofen, Post-thoracotomy pain, Pre-emptive epidural analgesia
  • Hatay Mustafa Kemal Üniversitesi Adresli: Hayır

Özet

Post thoracotomy chronic pain is a severe problem that affects the majority of patients and decreases the quality of life. The purpose of this study is to evaluate the long-term effects of thoracal epidural levobupivacaine and intravenous dexketoprofen analgesia formed pre-emptively on the wound site pain after major thoracotomy operations. This randomised, prospective and double-blind study was performed with 60 patients undergoing thoracic surgery. Patients were divided into three groups; Control Group (Group C), Pre-emptive Epidural Group (Group PE) and Pre-emptive Dexketoprofen + Epidural Group (Group PED). Patients in the Group C did not receive epidural analgesics and i.v. dexketoprofen before and during the operation. 10-15 ml 0.125% levobupivacaine was given to cases in Group PE pre-emptively through epidural catheter before the anesthesia induction. The cases in Group PED were given 10-15 ml 0.125% epidural levobupivacaine and 50 mg dexketoprofen with i.v. infusion pre-emptively. The VAS score was found to be lower in Group PED during postoperative 24 and 48 hours and before the discharge (P<0.05). The VAS score was similar in all groups during the first and third months (P>0.05). A statistically significant decrease was determined in the VAS score in Group PED during the sixth month, compared to the other groups (P<0.05). When the scores of Patient Satisfaction Scale (PSS) of the cases were compared, they were found to be higher in Group PED as statistically significant during the discharge period (P<0.001). Scores of PSS were higher in Group PED as statistically significant during the postoperative month 6 (P = 0.008). Combined application of pre-emptive intravenous dexketoprofen and thoracal epidural analgesia reduce the chronic post-thoracotomy pain.