Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy

Background: Post-surgical pain is a challenging problem. Different modifications of surgical procedures and use of different analgesics had been reported. However, no consensus had been reached for post-surgical pain control. Tonsillectomy is one of the most commonly performed surgical procedure and...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sabri A. Soltan, Nawal M. Alhulaimi, Mohsen M. Eissa
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2020
Materias:	acetaminophen ibuprofen opioid-free drug combination post-tonsillectomy pain Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/a5083394edbd41ea8cb6342d37a02171
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a5083394edbd41ea8cb6342d37a02171
record_format	dspace
spelling	oai:doaj.org-article:a5083394edbd41ea8cb6342d37a021712021-12-02T10:38:22ZOpioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy2636-41742682-378010.21608/ijma.2020.33699.1139https://doaj.org/article/a5083394edbd41ea8cb6342d37a021712020-10-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_109297_d9a3db7830a95a960108cce37be4a692.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Post-surgical pain is a challenging problem. Different modifications of surgical procedures and use of different analgesics had been reported. However, no consensus had been reached for post-surgical pain control. Tonsillectomy is one of the most commonly performed surgical procedure and pain control still controversial. Aim of the work:To investigation safety and efficacy of intravenous paracetamol, ibuprofen, or both for post-tonsillectomy pain control. Patients and Methods:The study had been carried at Otorhinolaryngology and Eye, Al-Jabr hospital,Anesthesia and Intensive Care Department in collaboration with Otorhinolaryngology department and the day care surgery unit], Al-Ahasa directorate, Kingdom of Saudi Arabia [KSA]. It included children aged 2 to 10 years. Patients had been randomly allocated into 3 equal groups [each 30 patients]. Group A [intravenous paracetamol 15mg/kg], Group B [intravenous ibuprofen 10mg/kg], and Group C [intravenous paracetamol 7.5 mg/kg and ibuprofen 5mg/kg]. The examined drug had been administrated 20 minutes after induction of general anesthesia. The analgesic effects and hemodynamics had been assessed on regular postoperative intervals till patient discharge, and patient satisfaction had been addressed. Any side effects and need for postoperative analgesia had been documented. Results: Studied groups were comparable regarding patient demographics, recovery time, hospital stay duration and need for additional analgesia. However, pain was significantly variable between studied groups till 3 hours postoperatively. Pain was significantly reduced at groups B [IV ibuprofen] and C [IV paracetamol and Ibuprofen with reduced dose] when compared to group A [IV paracetamol] at all times. In addition, hemodynamic variability was observed for mean arterial pressure and heart rate. At five minutes, blood pressure was significantly higher in group B when compared to group C, and at 5 minutes to 2.5 hours, it was significantly increased among group A when compared to group C. Conclusion: Drug combination with reduced [half the dose] of both intravenous paracetamol and ibuprofen is more effective and safer than single drug with higher dose. The studied drugs avoid the well-known side effects of opioids.Sabri A. SoltanNawal M. AlhulaimiMohsen M. EissaAl-Azhar University, Faculty of Medicine (Damietta)articleacetaminophenibuprofenopioid-freedrug combinationpost-tonsillectomy painMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 2, Iss 4, Pp 835-843 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	acetaminophen ibuprofen opioid-free drug combination post-tonsillectomy pain Medicine (General) R5-920
spellingShingle	acetaminophen ibuprofen opioid-free drug combination post-tonsillectomy pain Medicine (General) R5-920 Sabri A. Soltan Nawal M. Alhulaimi Mohsen M. Eissa Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
description	Background: Post-surgical pain is a challenging problem. Different modifications of surgical procedures and use of different analgesics had been reported. However, no consensus had been reached for post-surgical pain control. Tonsillectomy is one of the most commonly performed surgical procedure and pain control still controversial. Aim of the work:To investigation safety and efficacy of intravenous paracetamol, ibuprofen, or both for post-tonsillectomy pain control. Patients and Methods:The study had been carried at Otorhinolaryngology and Eye, Al-Jabr hospital,Anesthesia and Intensive Care Department in collaboration with Otorhinolaryngology department and the day care surgery unit], Al-Ahasa directorate, Kingdom of Saudi Arabia [KSA]. It included children aged 2 to 10 years. Patients had been randomly allocated into 3 equal groups [each 30 patients]. Group A [intravenous paracetamol 15mg/kg], Group B [intravenous ibuprofen 10mg/kg], and Group C [intravenous paracetamol 7.5 mg/kg and ibuprofen 5mg/kg]. The examined drug had been administrated 20 minutes after induction of general anesthesia. The analgesic effects and hemodynamics had been assessed on regular postoperative intervals till patient discharge, and patient satisfaction had been addressed. Any side effects and need for postoperative analgesia had been documented. Results: Studied groups were comparable regarding patient demographics, recovery time, hospital stay duration and need for additional analgesia. However, pain was significantly variable between studied groups till 3 hours postoperatively. Pain was significantly reduced at groups B [IV ibuprofen] and C [IV paracetamol and Ibuprofen with reduced dose] when compared to group A [IV paracetamol] at all times. In addition, hemodynamic variability was observed for mean arterial pressure and heart rate. At five minutes, blood pressure was significantly higher in group B when compared to group C, and at 5 minutes to 2.5 hours, it was significantly increased among group A when compared to group C. Conclusion: Drug combination with reduced [half the dose] of both intravenous paracetamol and ibuprofen is more effective and safer than single drug with higher dose. The studied drugs avoid the well-known side effects of opioids.
format	article
author	Sabri A. Soltan Nawal M. Alhulaimi Mohsen M. Eissa
author_facet	Sabri A. Soltan Nawal M. Alhulaimi Mohsen M. Eissa
author_sort	Sabri A. Soltan
title	Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
title_short	Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
title_full	Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
title_fullStr	Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
title_full_unstemmed	Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy
title_sort	opioid free postoperative pain management in day case surgery of tonsillectomy
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2020
url	https://doaj.org/article/a5083394edbd41ea8cb6342d37a02171
work_keys_str_mv	AT sabriasoltan opioidfreepostoperativepainmanagementindaycasesurgeryoftonsillectomy AT nawalmalhulaimi opioidfreepostoperativepainmanagementindaycasesurgeryoftonsillectomy AT mohsenmeissa opioidfreepostoperativepainmanagementindaycasesurgeryoftonsillectomy
_version_	1718396900359536640

Opioid Free Postoperative Pain Management in Day Case Surgery of Tonsillectomy

Ejemplares similares