The effect of preemptive intravenous dexketoprofen trometamol on quality of patient-controlled analgesia after abdominal hysterectomy

Abstract

Aim We investigated the fentanyl dose used in patient-controlled analgesia (PCA) of preemptive intravenous (IV) dexketoprofen trometamol (DKP) after abdominal hysterectomy. Material and Methods Following approval by the local ethics committee, 40 patients scheduled for ASA I-II abdominal hysterectomy were randomly divided into two groups. The anesthetic techniques were standardized. Group F (n=20): Placebo administered 30 minutes prior to operation and after 8 hours; Group D (n=20): 50mg IV dexketoprofen trometamol administered 30 minutes prior to operation and after 8 hours. When VAS>3, 1.5 μg/kg fentanyl was administered to both groups in the recovery room. At intervals and afterwards, analgesia was provided through PCA (bolus dose: 25 μg fentanyl; lock out period: 10 min.; 4-hr limit: 400 μg). VAS score, sedation score, fentanyl consumption, postoperative nausea and vomiting (PONV), and side-effects were recorded. Results Demographic data and duration of surgery in the two groups were similar. Respiratory depression was not seen in either group. There was no significant difference based on the VAS score (p= 0.07). Nausea and vomiting were significantly higher in the Group F compared to Group D (p=0.03). Compared to Group F, PONV were less in Group D, at 12hr and 24hr postoperatively (p=0.03). Fentanyl consumption at 12 and 24 hours was lower in Group D than Group F (p=0.001). Conclusions In cases where 50 mg of intravenous dexketoprofen trometamol was administered, we observed that the fentanyl consumption decreased by 40%, analgesia quality increased and the incidence of side-effects decreased.