Postoperative Analgesia After Hand Surgery: A Controlled Comparison of Dexketoprofen Trometamol and Paracetamol
Öz
Aim: This prospective, randomized, double-blind study compared the efficacy and safety of dexketoprofen trometamol (DT) and paracetamol in managing postoperative pain for patients undergoing intravenous regional anesthesia (IVRA) during hand surgery.
Methods: Sixty-six ASA I-II patients aged 18-70 were enrolled after exclusion criteria, including drug allergies, psychiatric disorders, Raynaud’s disease, and anticoagulant therapy. Patients were randomized into two groups: Group 1 received 25 mg DT, and Group 2 received 500 mg paracetamol for postoperative pain relief. At home postoperatively, pain intensity was assessed using the visual analog scale (VAS), and rescue analgesia was provided if needed. Patients recorded pain relief efficacy, satisfaction levels, side effects, and tablet consumption over 30 hours.
Results: While both DT and paracetamol provided adequate postoperative pain relief, key differences were observed. Group 1 reported significantly higher analgesic efficacy (p = 0.001) and satisfaction levels (p = 0.003), with 75.8% of patients experiencing complete pain relief compared to 42.4% in Group 2. Moreover, postoperative morphine requirements were significantly lower in Group 1 (p = 0.04), highlighting its superior ability to manage pain while minimizing opioid use. VAS scores at various postoperative intervals showed no statistically significant differences between the two groups. However, Group 1 reached peak pain intensity at 6 hours postoperatively, while Group 2 peaked at 12 hours, suggesting DT's faster onset of action. Both groups demonstrated similar demographic and surgical characteristics, ensuring robust comparability. The frequency of side effects, such as nausea, vomiting, headache, and insomnia, was low and comparable between the groups (p > 0.05), underscoring the safety profiles of both drugs.
Conclusions: DT offers superior postoperative pain control, reduced opioid reliance, and higher patient satisfaction compared to paracetamol following IVRA in ambulatory hand surgery. These findings support DT as a promising alternative to paracetamol in multimodal analgesia strategies. Additional studies are needed to confirm these findings and examine the mechanisms behind the differences in observed outcomes. The choice of analgesic should remain patient-specific, considering individual clinical conditions, contraindications, and preferences.
Anahtar Kelimeler
Kaynakça
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