Pre-emptive analgesia with nonsteroidal   anti-inflammatory drugs. Randomized, double-blind placebo-controlled study

SUMMARY
Background: Safety and effectiveness of dexketoprofen compared with ketorolac and placebo for pre-emtpive analgesia in oncological urology surgery.
Design: Single-center randomized double-blind, parallel, placebo controlled study. Participants: 111 patients, who were scheduled for the transurethral resection of the urinary bladder or prostatic gland under the spinal anesthesia. 91 patient fulfilled study requirements. Intervention: Pre-emptive analgesia 20 – 22 hours prior to the transurethral resection of the urinary bladder or prostatic gland using Dexketoprofen 25 mg 2 times per day (BID) and ketorolac 10 mg BID or placebo. Outcome: Postoperative pain severity and need in additional anesthesia in postoperative period.
Results: 111 patients (dexketoprofen n = 37, ketorolac n = 37, placebo n = 37) were randomized in the trial. Randomization was performed using programmed block method with 3 patients in a block. 2 patients of group (Gr.) D and 4 patients in groups K and P were excluded from the study due to the technical issues with the spinal puncture. There also were problems with samples of blood and liquor of 10 Gr. P patients, who were also excluded from the study and analysis, leaving 91 patients (n = 35; n = 33; n = 23) for analysis. Patients who received dexketoprofen a day before the operation had lower pain level during the first two days after the operation when compared to the patients, who received ketorolac and placebo (p = 0.001). Plasma prostaglandin E2 (PGE2) level (p < 0.05) and liquor (p = 0.0001) was lower in patients who received dexketoprofen before the operation, when compared to the patients who received ketorolak and placebo. There was no reliable difference in the glucose level and blood loss during the operation between 3 groups. No adverse events reported during the study.
Conclusions: Dexketoprofen injection in the dose 25 mg BID a day before the operation cause a significant reduction in pain level in the first two days of postoperative period after surgeries in oncological urology. This regimen does not cause an increase of blood loss during operation.
Key words: anesthesiology, nonsteroidal drugs, pain, pre-emptive analgesia, prostaglandin E2.
Lek Obz, 2021, 70 (5): 195-202

Pozn.: Práca vyšla v anglickom jazyku

Ivan LISNYY 1, Olesya ZAKALSKA 1, Dmytro DMYTRIIEV 2, Kostiantyn DMYTRIIEV 2, Oleksandr DOBROVANOV 3

1 National Cancer Institute, Anesthesiology department, head prof. MD. I. LISNYY, PhD.
2 Vinnytsia National Pirogov Memorial Medical University, head academician prof. V. M. Moroz, PhD., Sc.D.
3 A. Getlik Clinic for Children and Adolescents, Slovak Medical University and University Hospital of Medicine, Bratislava, Slovakia, head doc. MUDr. K. Furkova, CSc.

Citácia:
LISNYY I., ZAKALSKA O., DMYTRIIEV D., DMYTRIIEV K., DOBROVANOV O.:  Preemptívna analgézia s požitím nesteroidových protizápalových liekov. Randomizovaná dvojito zaslepená, placebom kontrolovaná štúdia.

Cite:
LISNYY I., ZAKALSKA O., DMYTRIIEV D., DMYTRIIEV K., DOBROVANOV O.: Pre-emptive analgesia with nonsteroidal   anti-inflammatory drugs. Randomized, double-blind placebo-controlled study