Mutlu Vahit, Ince Ilker
Atatürk University, Faculty of Medicine, Department of Otorhinolaryngology, Erzurum, Turkey.
Atatürk University, Faculty of Medicine, Department of Anesthesiology, Erzurum, Turkey.
Am J Otolaryngol. 2019 Jan-Feb;40(1):70-73. doi: 10.1016/j.amjoto.2018.10.008. Epub 2018 Oct 16.
The primary aim of this study was to investigate the effects of preemptive a single dose IV ibuprofen on postoperative 48 h opioid consumption and postoperative pain in patients undergoing thyroidectomy.
The study included 40 patients aged 18 to 65, scheduled for elective thyroidectomy. Patients were randomly divided into 2 groups. Control group (n = 20) received 100 mL saline solution 15 min before surgery, while study group (n = 20) received 800 mg IV ibuprofen in 100 mL saline. The same general anesthesia protocol was applied in both groups, and all operations were performed by the same surgical team using the same technique. Postoperative analgesia was assessed using a visual analogue scale (VAS) and the amount of consumption of 48 h postoperative fentanyl with patient-controlled analgesia (PCA) and additional analgesia requirements were recorded. When additional analgesia was required, 1000 mg IV paracetamol was used.
VAS scores in the ibuprofen group were found lower than the control group in the all-time points (p < 0.05). Opioid consumption in the 48 h was significantly higher in the control group than the ibuprofen group (p < 0.001). Using of rescue analgesia was significantly higher in the control group than the ibuprofen group, statistically (p < 0.05). A significant difference was observed between two groups in terms of side effects of fentanyl consumption (nausea and vomiting) (p < 0.001).
To use preemptive a single dose IV ibuprofen decreases pain scores and postoperative opioid consumption in patients following thyroidectomy. Additionally, this application increase the patient comfort reducing nausea and vomiting in early postoperative period.
本研究的主要目的是调查术前单次静脉注射布洛芬对甲状腺切除术后48小时阿片类药物消耗量及术后疼痛的影响。
本研究纳入40例年龄在18至65岁、计划行择期甲状腺切除术的患者。患者被随机分为2组。对照组(n = 20)在手术前15分钟接受100 mL生理盐水,而研究组(n = 20)接受100 mL生理盐水中含800 mg静脉注射布洛芬。两组采用相同的全身麻醉方案,所有手术均由同一手术团队使用相同技术进行。使用视觉模拟评分法(VAS)评估术后镇痛情况,并记录术后48小时患者自控镇痛(PCA)时芬太尼的消耗量以及额外镇痛需求。当需要额外镇痛时,使用1000 mg静脉注射对乙酰氨基酚。
布洛芬组的VAS评分在所有时间点均低于对照组(p < 0.05)。对照组48小时内的阿片类药物消耗量显著高于布洛芬组(p < 0.001)。对照组使用补救性镇痛剂的情况显著高于布洛芬组,具有统计学意义(p < 0.05)。两组在芬太尼使用的副作用(恶心和呕吐)方面观察到显著差异(p < 0.001)。
术前单次静脉注射布洛芬可降低甲状腺切除术后患者的疼痛评分及术后阿片类药物消耗量。此外,这种应用可提高患者舒适度并减少术后早期的恶心和呕吐症状。