بررسی مقایسه‌ای تأثیر تجویز دو پیش‌داروی وریدی کتورولاک و پاراستامول بر بی‌دردی پس از اعمال جراحی شکم

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، مرکز تحقیقات بیهوشی و مراقبت‌های ویژه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: درد پس از عمل، شایع‌ترین عارضه‌ی اعمال جراحی است که تا کنون مطالعات مختلفی در مورد کاهش بروز آن صورت گرفته است. این مطالعه، با هدف مقایسه‌ی تأثیر تجویز دو پیش‌داروی وریدی کتورولاک و پاراستامول بر بی‌دردی پس از اعمال جراحی شکم انجام شد.روش‌ها: طی یک مطالعه‌ی کارآزمایی بالینی، 80 بیمار کاندیدای اعمال جراحی شکم به روش تصادفی در دو گروه 40 نفره توزیع شدند. در گروه اول، 30 میلی‌گرم کتورولاک وریدی و در گروه دوم 1 گرم پاراستامول وریدی در یک ساعت قبل از عمل جراحی به بیماران تزریق شد. بروز و شدت درد در دو گروه بررسی و مقایسه گردید.یافته‌ها: میانگین شدت درد در ریکاوری در دو گروه پاراستامول و کتورولاک به ترتیب 9/0 ± 4/7 و 0/2 ± 9/5 بود و اختلاف معنی‌داری بین دو گروه دیده شد (001/ > P). همچنین، شدت درد در 2، 6 و 18 ساعت بعد از عمل در گروه کتورولاک کمتر بود و روند تغییرات شدت درد در طی مدت مطالعه در دو گروه اختلاف معنی‌داری داشت (034/0 = P)، اما بروز تهوع و استفراغ در گروه کتورولاک به طور معنی‌داری بیشتر بود.نتیجه‌گیری: تزریق کتورولاک در قبل از عمل بروز کمتر درد بعد از عمل و بروز بیشتر تهوع و استفراغ بعد از عمل را به همراه دارد. از طرف دیگر، داروهای ضد التهاب غیر استروئیدی در برخی بیماران محدودیت مصرف دارد، از این رو، احتمال می‌‌رود پاراستامول بتواند جایگزین مناسبی برای کنترل درد بعد از عمل در این بیماران باشد. در عین حال، انجام مطالعات بیشتر در این زمینه توصیه می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the Preemptive Effect of Intravenous Paracetamol and Ketorolac on Prevention of Postoperative Pain in Patients Undergoing Abdominal Surgery

نویسندگان [English]

  • Hamid Saryazdi 1
  • Omid Aghadavoudi 1
  • Shiva Fakhari 2
1 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Postoperative pain is one of the most prevalent complications after the surgery and several studies have been performed for prevention of it. This study aimed to compare the preemptive effect of intravenous paracetamol and ketorolac on prevention of postoperative pain in patients undergoing abdominal surgeries.Methods: In a clinical trial study, 80 patients undergoing abdominal surgery were selected and randomly divided into two groups of 40. The first and second groups received 30 mg intravenous paracetamol and 1 g intravenous ketorolac, respectively, one hour before the beginning of surgery. Incidence and intensity of postoperative pain were compared between the two groups.Findings: The mean score of postoperative pain in paracetamol and ketorolac groups in recovery were 7.4 ± 0.9 and 5.9 ± 2.0, respectively and the difference between the groups was statistically significant (P < 0.001). In addition, postoperative pain intensity in 2, 6, and 18 hours after the surgery was lower in ketorolac group. The mean change of postoperative pain intensity was different in the two groups (P = 0.034). But, the incidence of nausea and vomiting was higher in ketorolac group.Conclusion: Injection of paracetamol led to more decrease in postoperative pain; but the incidence of postoperative nausea and vomiting was higher with ketorolac. As using non-steroidal anti-inflammatory drugs in some of patients is limited, probably paracetamol is a suitable drug for prevention of postoperative pain. Although, more studies is recommended.

کلیدواژه‌ها [English]

  • Postoperative pain
  • Paracetamol
  • Ketorolac
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