Preemptive Effects of a Combination of Preoperative Diclofenac, Butorphanol: RESULTS

In: Anesthesia

6 Feb 2010

The 2 groups were similar in sex, age, weight, and duration of surgery (Table 1). There were no significant differences between the 2 groups in POPI scores at FWI (3 hours after extubation) or at 24, 48, and 72 hours after extubation except for those recorded in the PACU (1 hour after extubation) (Figures 1 and 2). There were 33 patients in group P and 34 patients in group С who requested postoperative analgesics. No significant group difference was observed in the period from extubation to the first administration of postoperative analgesics (Figure 3). The total number of postoperative sodium administrations was not statistically different between the 2 groups (Table 2). The number of patients who received postoperative analgesic supplement was not statistically different between the 2 groups after surgery (Table 3). The mean values of ETISO, SBP, HR, and RPP were significantly lower in group P than in group C. The CVs of SBP, HP, and RPP were not significantly different between the 2 groups (Table 4). Table 5 summarizes the intervals from administration of diclofenac sodium and butorphanol to incision, end of surgery, and NRS assessment in group P.

Figure 1. Postoperative pain intensity

Figure 1. Postoperative pain intensity at rest (POPI). There were no significant differences between the 2 groups in POPI scores at 24, 48, and 72 hours after extubation except for those recorded in the postanesthesia care unit (PACU) (1 hour after extubation). Group P, preemptive multimodal analgesia group; group C, control group; NRS, numerical rating score ranging from 0 (no pain) to 10 (worst pain); VAS, visual analogue scale from 0 mm (no pain) to 100 mm (worst pain). POPI in PACU was assessed using NRS and that at 24, 48, and 72 hours after extubation was assessed using VAS. P < .05 between the 2 groups.

Table 1.

Group P

Group С

(n = 41)

(n = 41)

Male (n) 13 16
Female (n) 28 25
Age (years) 20.9 ± 3.7 22.4 ± 4.4
Weight (kg) 58.6 ± 8.9 57.1 ± 8.9
Duration of surgery (minutes) 137.3 ± 44.9 136.0 ± 43.6
* Group P, preemptive multimodal analgesia group; group C, control group.

Table 2. Total Number of Postoperative Diclofenac Sodium Doses Administered During the 72 Hours After Extubation*

Number

of

analgesic

Group P Group С

administrations

(n = 41) (n = 41)
0

8

7
1

11

13

2

10

7

3 or more

12

14

Figure 2. Postoperative pain intensity

Figure 2. Postoperative pain intensity at rest (POPI) at the first water intake (FWI). There were no significant differences between the 2 groups in POPI scores at FWI (3 hours after extubation). Group P, preemptive multimodal analgesia group; group C, control group; group A, the patient who received postoperative analgesic supplement before FWI; group NA, the patient who did not receive postoperative analgesic supplement before FWI; VAS, visual analogue scale from 0 mm (no pain) to 100 mm (worst pain).

Table 3. Number of Patients Who Received the Postopera-tive Analgesic Supplement*

Group P (n = 41)

Group С (n = 41)
Day of surgery 33

34

1 day after surgery 17

15

2 days after surgery 9

13

3 days after surgery 7

3

Table 4. Average of Mean Value and Coefficient of Variation (CV) of End-tidal Isoflurane Concentration (ETISO), Systolic Blood Pressure (SBP), Heart Rate (HR), and Rate Pressure Product (RPP) (Mean ± SD)t

Group P (n = 41)

Group С (n = 41)

Mean value
ETISO (%) 1.14 ± 0.33 * 1.61 ± 0.50
SBP (mm Hg) 101.3 ± 9.6 * 110.8 ± 9.2
HR (beats/min) 93.0 ± 14.2 * 109.6 ± 12.8
RPP 9498.6 ± 1941.5 * 12,215.6 ± 1901.2
CV
SBP (%) 10.0 ± 15.8 NS 8.8 ± 2.5
HR (%) 8.0 ± 3.4 NS 8.0 ± 2.4
RPP (%) 15.4 ± 15.3 NS 14.9 ± 4.0
t Group P, preemptive multimodal analgesia group; group C, control group; NS, not significant. * P < .05 between the 2 groups.

Figure 3. The interval from extubation

Figure 3. The interval from extubation to the first administration of postoperative analgesics. No significant group difference was observed. 0, the time of extubation; group P, preemptive multimodal analgesia group; group C, control group. There were 33 patients in group P and 34 patients in group С who requested postoperative analgesics.

Table 5. Intervals From Administration of Diclofenac Sodium and Butorphanol Tartrate to Incision, End of Surgery, and Numerical Rating Score (NRS) Assessment in Group P (Mean ± SD)

Butorphanol Tartrate

Diclofenac generic Sodium

Interval from administration to
incision (minute) 41.8 ± 8.6 32.4 ± 7.9
Interval from administration to
end of surgery (minute) 179.1 ± 47.0 169.8 ± 46.8
Interval from administration to
assessment of NRS (minute) 227.2 ± 49.4 217.8 ± 49.3

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