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Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty

Year 2010, Volume: 12 Issue: 2, 42 - 47, 01.07.2010

Abstract

Objective: Intravenous (IV) paracetamol (acetaminophen) is an analgesic and antipyretic medication that can be used for reduction of postoperative pain. In this study, we compared the efficacies of IV paracetamol and intramuscular (IM) diclofenac on postoperative pain following septoplasty. Material and Method: In this study, 27 of 54 patients who had septoplasty were administered IV 1 gr paracetamol with six hours intervals (q.i.d.) after surgery while the other 27 patients received 75 mg diclofenac IM with 12 hours intervals (b.i.d.). Vital signs, electrocardiogram, and blood chemistry were obtained prior to administration of drugs and 24 hours postoperatively for detection of any possible side effects. Results: Both preparations were equally effective for controlling postoperative pain. There were no side effects in any of the groups. Statistical analysis did not reveal any difference between the groups (P > 0.05). Conclusion: Although there were no statistically significant differences between IV paracetamol and IM diclofenac for reduction of the postoperative pain, more frequent administration of paracetamol and 15 minute of infusion caused problems in early mobilization of patients when compared to diclofenac group. Total cost of the therapy was also in favor of diclofenac. Diclofenac was also cost-effective

References

  • Kokki H. Nonsteroidal anti-inflammatory drugs for postoperative pain: a focus on children. Paediatr Drugs 5(2):103–123, 2003.
  • Warfield CA, Kahn CH. Acute pain management. Programs in U.S. hospitals and experiences and attitudes among U.S.adults. Anesthesiology 83,1090–1094, 1995.
  • Pavlin DJ, Chen C, Penaloza DA, Polissar NL, Buckley FP. Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesth Analg. 95.627–634, 2002.
  • McGrath B, Elgendy H, Chung F, Kamming D,Curti B, King S. Thirty peercent of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5703 patients. Can J Anaesth 51:886–891, 2004.
  • Salonen A, Kokki H, Nuutinen J. Recovery after tonsillectomy in adults: a three week follow-up study. Laryngoscope 112:94- 98, 2002.
  • Kemppainen T, Kokki H, Tuomilehto H, Seppa J, Nuutinen J. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery. Laryngoscope 116: 2125- 2128, 2006.
  • Barden J, Edwards J, Moore A, McQuey H. Single dose oral paracetamol (acetaminophen) for postoperative pain. Cochrane Database Syst Rev 1: CD004602, 2004.
  • Haas DA. An update on analgesics for the management of acute postoperative dental pain. J Can Dent Assoc 68 (8): 476– 82, 2002.
  • Moller PL, Juhl GL, Payen-Champenois C, Skoglund LA. Intravenous acetaminophen ( paracetamol ): comparable analgesic efficacy, but beter local safety than its prodrug,propacetamol for postoperative pain after third molar surgery. Anesth Analg 101,90–6, 2005.
  • Landwehr S, Kiencke P, Giesecke T, Eggert D, Thumann G, Kampe S. A comparison between IV paracetamol and IV metamizol for postoperative analgesia after retinal surgery. Curr Med Res Opin. 21(10):1569-75, 2005.
  • Sinatra RS, Jahr JS, Reynolds LW, Viscusi ER, Groudine SB, Payen-Champenois C. Efficacy and safety of single and repeated administration of 1 gr intravenous acetaminophen injection ( paracetamol ) for pain management after major orthopedic surgery. Anesthesiology 102: 822–31, 2005.
  • Dahl JB, Kehlet H. Non-steroidal and anti-inflammatory drugs: nationale for use in severe postoperative pain. Br J Anaesth 66.703–712, 1991.
  • Kemppainen T, Kokki H, Tuomilehto H, Seppa J, Nuutinen J. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery.Laryncoscope 116(12):2125-28, 2006.
  • Baer GA, Rorarius MGF, Kolehmainen S,Selin S. The effect of paracetamol or diclofenac administered before operation on postoperative pain and behaviour after adenoidectomy in small children. Anaesthesia 47: 1078- 80, 1992.
  • Atef A, Fawaz AA. Intravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults. Eur Arch Otorhinolaryngol. 265(3): 351-355, 2008.
  • Lingren U, Djupso H. Diclofenac for pain after hip surgery. Acta Orthop Scand 56: 26-31, 1985.
  • Alexander R, El-Moalem HE,Gan TJ. Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery. J Clin Anesth 14:187–92, 2002.
  • Hyllested M, Jones S, Pedersen JL, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth 88:199-214, 2002.
  • Beaussier M, Weickmans H, Paugam C, Lavazais S, Baechle JP, Goater P et al. A rndomized ,double-blind comparison between parecoxib sodium and propacetamol for parenteral postoperative analgesia after inguinal hernia repair in adult patients. Anesth Analg 100(5):1309-15, 2005.
  • Wright J. The double-edged sword of COX–2 selective NSAIDs. Can Med Assoc J 167: 1131-7, 2002.
  • Brater C. Renal effects of cyclooxygenase- 2 -selective inhibitors. J Pain Symptom Manage 23:S15-S20, 2002.
  • Murphy EJ. Acute pain management pharmacology for the patient with concurrent renal or hepatic disease. Anaesth Intensive Care 33: 311- 22, 2005.
  • Munsterhjelm E, Munsterhjelm NM, Niemi TT, Ylikorkala O, Neuvonen PJ, Rosenberg PH. Dose-dependent inhibition of platelet function by acetaminophen in healthy volunteers. Anesthesiology 103(4):712-7, 2005.
  • Sheen CL, Dillon JF, Bateman DN, Simpson KJ, MacDonald TM. Paracetamol toxicity: epidemiology, prevention and costs to the health care system. Q J Med 95: 609–19, 2002.

Parenteral Parasetamol ve Diklofenakın Septoplasti Sonrası Ağrı Kesici Etkisi

Year 2010, Volume: 12 Issue: 2, 42 - 47, 01.07.2010

Abstract

Amaç: IV acetaminophen (paracetamol) post-operatif olarak kullanılabilen analjezik ve antipiretik etkili bir preparattır. Bu çalışmada intravenöz parasetamolün ve intramüsküler olarak kullanılan diclofenak’ın postoperatif ağrılardaki etkinlikleri karşılaştırıldı. Materyal ve Metod: Bu çalışmada toplam 54 hastanın 27'sine 6 saat arayla 1gr IV paracetamol, 27'sine ise 12 saatte bir IM olarak diclofenak verildi. İlaç uygulamasından önce ve operasyondan 24 saat sonra oluşabilecek yan etkiler; vital bulgular, elektrokardiyografik (EKG) ve biyokimyasal olarak kontrol edildi. Bulgular: Her iki preparat da postoperatif ağrı kontrolünde oldukça etkiliydi. Gruplarda herhangi bir yan etki gözlenmedi. İstatistik analizler sonucunda gruplar arasında anlamlı bir fark görülmedi. Sonuç: İntravenöz uygulanan 1g paracetamol ile intramüsküler olarak uygulanan 75mg diclofenak arasında post operatif olarak ağrıyı azaltmadaki etkilerinde istatistiksel olarak anlamlı fark olmamasına rağmen parasetamolün her 6 saatte bir uygulanması ve uygulama sürecinin 15 dakika olması diclofenak grubu hastalarına göre erken mobilizasyonda sorun teşkil etmiştir. Ayrıca total maliyet hesaplandığında diclofenacın kulak burun boğaz ameliyatlarından sonra daha çok tercih edilebileceği düşüncesine varılmıştır.

References

  • Kokki H. Nonsteroidal anti-inflammatory drugs for postoperative pain: a focus on children. Paediatr Drugs 5(2):103–123, 2003.
  • Warfield CA, Kahn CH. Acute pain management. Programs in U.S. hospitals and experiences and attitudes among U.S.adults. Anesthesiology 83,1090–1094, 1995.
  • Pavlin DJ, Chen C, Penaloza DA, Polissar NL, Buckley FP. Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesth Analg. 95.627–634, 2002.
  • McGrath B, Elgendy H, Chung F, Kamming D,Curti B, King S. Thirty peercent of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5703 patients. Can J Anaesth 51:886–891, 2004.
  • Salonen A, Kokki H, Nuutinen J. Recovery after tonsillectomy in adults: a three week follow-up study. Laryngoscope 112:94- 98, 2002.
  • Kemppainen T, Kokki H, Tuomilehto H, Seppa J, Nuutinen J. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery. Laryngoscope 116: 2125- 2128, 2006.
  • Barden J, Edwards J, Moore A, McQuey H. Single dose oral paracetamol (acetaminophen) for postoperative pain. Cochrane Database Syst Rev 1: CD004602, 2004.
  • Haas DA. An update on analgesics for the management of acute postoperative dental pain. J Can Dent Assoc 68 (8): 476– 82, 2002.
  • Moller PL, Juhl GL, Payen-Champenois C, Skoglund LA. Intravenous acetaminophen ( paracetamol ): comparable analgesic efficacy, but beter local safety than its prodrug,propacetamol for postoperative pain after third molar surgery. Anesth Analg 101,90–6, 2005.
  • Landwehr S, Kiencke P, Giesecke T, Eggert D, Thumann G, Kampe S. A comparison between IV paracetamol and IV metamizol for postoperative analgesia after retinal surgery. Curr Med Res Opin. 21(10):1569-75, 2005.
  • Sinatra RS, Jahr JS, Reynolds LW, Viscusi ER, Groudine SB, Payen-Champenois C. Efficacy and safety of single and repeated administration of 1 gr intravenous acetaminophen injection ( paracetamol ) for pain management after major orthopedic surgery. Anesthesiology 102: 822–31, 2005.
  • Dahl JB, Kehlet H. Non-steroidal and anti-inflammatory drugs: nationale for use in severe postoperative pain. Br J Anaesth 66.703–712, 1991.
  • Kemppainen T, Kokki H, Tuomilehto H, Seppa J, Nuutinen J. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery.Laryncoscope 116(12):2125-28, 2006.
  • Baer GA, Rorarius MGF, Kolehmainen S,Selin S. The effect of paracetamol or diclofenac administered before operation on postoperative pain and behaviour after adenoidectomy in small children. Anaesthesia 47: 1078- 80, 1992.
  • Atef A, Fawaz AA. Intravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults. Eur Arch Otorhinolaryngol. 265(3): 351-355, 2008.
  • Lingren U, Djupso H. Diclofenac for pain after hip surgery. Acta Orthop Scand 56: 26-31, 1985.
  • Alexander R, El-Moalem HE,Gan TJ. Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery. J Clin Anesth 14:187–92, 2002.
  • Hyllested M, Jones S, Pedersen JL, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth 88:199-214, 2002.
  • Beaussier M, Weickmans H, Paugam C, Lavazais S, Baechle JP, Goater P et al. A rndomized ,double-blind comparison between parecoxib sodium and propacetamol for parenteral postoperative analgesia after inguinal hernia repair in adult patients. Anesth Analg 100(5):1309-15, 2005.
  • Wright J. The double-edged sword of COX–2 selective NSAIDs. Can Med Assoc J 167: 1131-7, 2002.
  • Brater C. Renal effects of cyclooxygenase- 2 -selective inhibitors. J Pain Symptom Manage 23:S15-S20, 2002.
  • Murphy EJ. Acute pain management pharmacology for the patient with concurrent renal or hepatic disease. Anaesth Intensive Care 33: 311- 22, 2005.
  • Munsterhjelm E, Munsterhjelm NM, Niemi TT, Ylikorkala O, Neuvonen PJ, Rosenberg PH. Dose-dependent inhibition of platelet function by acetaminophen in healthy volunteers. Anesthesiology 103(4):712-7, 2005.
  • Sheen CL, Dillon JF, Bateman DN, Simpson KJ, MacDonald TM. Paracetamol toxicity: epidemiology, prevention and costs to the health care system. Q J Med 95: 609–19, 2002.
There are 24 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Selahattin Genç This is me

Umit Tuncel This is me

H Mete İnançlı This is me

Ayse Canan Yazıcı This is me

Abdurrahman Yurtaslan This is me

Damla Guclu Guven This is me

Publication Date July 1, 2010
Published in Issue Year 2010 Volume: 12 Issue: 2

Cite

APA Genç, S., Tuncel, U., İnançlı, H. M., Yazıcı, A. C., et al. (2010). Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty. Duzce Medical Journal, 12(2), 42-47.
AMA Genç S, Tuncel U, İnançlı HM, Yazıcı AC, Yurtaslan A, Guven DG. Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty. Duzce Med J. July 2010;12(2):42-47.
Chicago Genç, Selahattin, Umit Tuncel, H Mete İnançlı, Ayse Canan Yazıcı, Abdurrahman Yurtaslan, and Damla Guclu Guven. “Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty”. Duzce Medical Journal 12, no. 2 (July 2010): 42-47.
EndNote Genç S, Tuncel U, İnançlı HM, Yazıcı AC, Yurtaslan A, Guven DG (July 1, 2010) Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty. Duzce Medical Journal 12 2 42–47.
IEEE S. Genç, U. Tuncel, H. M. İnançlı, A. C. Yazıcı, A. Yurtaslan, and D. G. Guven, “Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty”, Duzce Med J, vol. 12, no. 2, pp. 42–47, 2010.
ISNAD Genç, Selahattin et al. “Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty”. Duzce Medical Journal 12/2 (July 2010), 42-47.
JAMA Genç S, Tuncel U, İnançlı HM, Yazıcı AC, Yurtaslan A, Guven DG. Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty. Duzce Med J. 2010;12:42–47.
MLA Genç, Selahattin et al. “Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty”. Duzce Medical Journal, vol. 12, no. 2, 2010, pp. 42-47.
Vancouver Genç S, Tuncel U, İnançlı HM, Yazıcı AC, Yurtaslan A, Guven DG. Pain Reducing Effect Of Parenteral Paracetamol and Diclofenac After Septoplasty. Duzce Med J. 2010;12(2):42-7.