Canadian Journal of Anaesthesia

, Volume 44, Issue 5, pp 479–485 | Cite as

Postoperative analgesia withiv propacetamol and ketoprofen combination after disc surgery

  • D. Fletcher
  • I. Nègre
  • C. Barbin
  • A. François
  • C. Carreres
  • C. Falgueirettes
  • A. Barboteu
  • K. Samii
Reports of Investigation

Abstract

Purpose

The concept of balanced analgesia suggests that a combination of analgesic drugs may enhance analgesia and reduce side effects after surgery. This study evaluated the effect of the combination of propacetamol (Prodafalgan) and ketoprofen (Profenid) after surgery of a hemiated disc of the lumbar spine.

Methods

After randomization. 60 patients received: placebo (group 1); 2 g propacetamol (group 2); 50 mg ketoprofen (group 3); or a combination of 2 g propacetamol and 50 mg ketoprofen (group 4). Drugs were administered every six hours for two days after surgery. The patients used morphine with patient controlled analgesia pumps (bolus 1mg; lock out time 10 min) and were evaluated with a visual analogue scale (VAS) at rest and movement every six hours for two days. Side effects were noted.

Results

The patient characteristics and surgery were identical for each of the four groups. The VAS scores throughout the study were lower in group 4 than in groups 1, 2 and 3 both at rest (P < 0.05) and on movement (P < 0.01). The cumulative dose of morphine at 48 hr was lower in group 4 than in group 1 (23.4 ± 5 mg vs 58.9 ± 9 mg; P < 0.01) or group 2 (23.4 ± 5 mg vs 43.4 ± 6.6 mg; P < 0.05) and similar to that in group 3 (34.2 ± 4.5 mg). The incidence of side effects was similar in all groups.

Conclusion

The combination of propacetamol and ketoprofen reduced pain scores both at rest and on movement. The drug combination did not reduce the morphine consumption and incidence of side effects.

Résumé

But

Le concept d’analgésie balancée suggère que I’association de drogues analgésiques en postopératoire peut permettre d’améliorer I’analgésie et réduire les effets secondaires. Cette étude a évalué I’intérêt d’une association de propacetamol (Prodafalgan) et de ketoprofen (Profenid) pour I’analgésie après chirurgie d’une hernie discale lombaire.

Méthodes

Après randomisation 60 patients ont reçu: un placebo (groupe 1); 2 g de propacetamol (groupe 2); 50 mg de ketoprofen (groupe 3); où I’association de 2 g de propacetamol et 50 mg de ketoprofen (groupe 4). Les produits analgésiques ont été administrés toutes les six heures pendant 48 h. Les patients utilisaient de la morphine grâce à une pompe d’analgésie autocontrôlée pendant 48 h (bolus 1mg; période réfractaire 10 mm) et la douleur était évaluée par échelle visuelle analogique toutes les six heures au repos et au mouvement. Les effets secondaires étaient notés toutes les six heures.

Resultats

Les patients et la chirurgie étaient similaires dans les quatre groupes. Les scores d’EVA etaient plus bas pendant les 48 heures de I’étude dans le groupe 4 par rapport à ceux des groupes 1, 2 et 3 au repos (P < 0.05) comme au mouvement (P < 0.01). Les doses cumulées de morphine étaient significativement plus basses à 48 h dans le groupe 4 par rapport au groupe 1 (23.4 ± 5 mg vs 58.9 ± 9 mg; P < 0.01). groupe 2 (23.4 ± 5 mgvs 43.4 ± 6.6 mg; P < 0.05) et pas significativement différentes de celles du groupe 3 (34.2 ± 4.5 mg). L’incidence des effets secondaires était similaire dans tous les groupes.

Conclusion

L’association de propacetamol et ketoprofen a réduit les scores de douleur au repos et au mouvement par rapport aux groupes traités par une seule drogue analgésique. Lassociation propacetamol-ketoprofen n’a pas significativement réduit la consommation de morphine et les effets secondaires Iiés à la morphine.

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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  • D. Fletcher
    • 1
  • I. Nègre
    • 1
  • C. Barbin
    • 1
  • A. François
    • 1
  • C. Carreres
    • 1
  • C. Falgueirettes
    • 1
  • A. Barboteu
    • 1
  • K. Samii
    • 1
  1. 1.Département of Anesthésie RéanimationHôpital BicêtreBicêtre CedexFrance

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