Danguole Rugyte1, Hannu Kokki. 1. Department of Anesthesiology, Kaunas University of Medicine, Eiveniu 2, Kaunas, Lithuania. danguole.rugyte@kmuk.lt
Abstract
BACKGROUND: Surgery to correct pectus deformities entail substantial destruction of the thoracic skeleton and thus may cause significant postoperative pain. AIMS: To evaluate the efficacy of intravenous ketoprofen, a NSAID, as an adjunct to PCA morphine in pain treatment in children having pectus surgery. METHODS:Thirty-one children aged 10-15 years completed the study according to protocol. Children (n=14) in theketoprofen-group received ketoprofen 1mg/kg i.v. at the skin closure, and at 8 and 16 h after surgery, while children (n=17) in the placebo-group received normal saline, respectively. For rescue analgesia the patient had an access to PCA-morphine. The children expressed their pain by a coloured VAS. RESULTS: Mean cumulative 24h morphine dose used was less in the ketoprofen-group (mean+/-SD: 490+/-240 microg/kg) than in the placebo-group (670+/-200 microg/kg) (mean difference 180 microg/kg, 95% CI for diff: 15-340 microg/kg, P=0.03). The area under the pain intensity-time-curve was lower in the ketorpofen-group (49+/-26 score hour) than in the placebo-group (68+/-24 score hour) (mean difference 21 score hour, 95% CI for diff: 3-40 score hour, P=0.026). There was no difference between the two groups in adverse events, 4/14 in the ketoprofen group and 8/17 in the placebo-group developed oxygen desaturation, and one patient in the ketoprofen-group developed bleeding at 5h after surgery. CONCLUSIONS:Intravenous ketoprofen in adjunct to PCA morphine provided a significant opioid sparing effect and improved analgesia in children having chest wall correction surgery.
RCT Entities:
BACKGROUND: Surgery to correct pectus deformities entail substantial destruction of the thoracic skeleton and thus may cause significant postoperative pain. AIMS: To evaluate the efficacy of intravenous ketoprofen, a NSAID, as an adjunct to PCA morphine in pain treatment in children having pectus surgery. METHODS: Thirty-one children aged 10-15 years completed the study according to protocol. Children (n=14) in the ketoprofen-group received ketoprofen 1mg/kg i.v. at the skin closure, and at 8 and 16 h after surgery, while children (n=17) in the placebo-group received normal saline, respectively. For rescue analgesia the patient had an access to PCA-morphine. The children expressed their pain by a coloured VAS. RESULTS: Mean cumulative 24h morphine dose used was less in the ketoprofen-group (mean+/-SD: 490+/-240 microg/kg) than in the placebo-group (670+/-200 microg/kg) (mean difference 180 microg/kg, 95% CI for diff: 15-340 microg/kg, P=0.03). The area under the pain intensity-time-curve was lower in the ketorpofen-group (49+/-26 score hour) than in the placebo-group (68+/-24 score hour) (mean difference 21 score hour, 95% CI for diff: 3-40 score hour, P=0.026). There was no difference between the two groups in adverse events, 4/14 in the ketoprofen group and 8/17 in the placebo-group developed oxygen desaturation, and one patient in the ketoprofen-group developed bleeding at 5h after surgery. CONCLUSIONS: Intravenous ketoprofen in adjunct to PCA morphine provided a significant opioid sparing effect and improved analgesia in children having chest wall correction surgery.
Authors: Tong J Gan; Neil Singla; Stephen E Daniels; Douglas A Hamilton; Peter G Lacouture; Christian Rd Reyes; Daniel B Carr Journal: J Pain Res Date: 2016-12-20 Impact factor: 3.133