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Intravenous ketoprofen as an adjunct to patient‐controlled analgesia morphine in adolescents with thoracic surgery: A placebo controlled double‐blinded study

2006; Wiley; Volume: 11; Issue: 6 Linguagem: Inglês

10.1016/j.ejpain.2006.11.001

1532-2149

Danguolė Česlava Rugytė, Hannu Kokki,

Nerve Injury and Rehabilitation

Abstract Background: Surgery to correct pectus deformities entail substantial destruction of the thoracic skeleton and thus may cause significant postoperative pain. Aims: To evaluate the efficacy of intravenous ketoprofen, a NSAID, as an adjunct to PCA morphine in pain treatment in children having pectus surgery. Methods: Thirty‐one children aged 10–15 years completed the study according to protocol. Children ( n = 14) in the ketoprofen‐group received ketoprofen 1 mg/kg i.v. at the skin closure, and at 8 and 16 h after surgery, while children ( n = 17) in the placebo‐group received normal saline, respectively. For rescue analgesia the patient had an access to PCA‐morphine. The children expressed their pain by a coloured VAS. Results: Mean cumulative 24 h morphine dose used was less in the ketoprofen‐group (mean ± SD: 490 ± 240 μg/kg) than in the placebo‐group (670 ± 200 μg/kg) (mean difference 180 μg/kg, 95% CI for diff: 15–340 μg/kg, P = 0.03). The area under the pain intensity–time‐curve was lower in the ketorpofen‐group (49 ± 26 score hour) than in the placebo‐group (68 ± 24 score hour) (mean difference 21 score hour, 95% CI for diff: 3–40 score hour, P = 0.026). There was no difference between the two groups in adverse events, 4/14 in the ketoprofen group and 8/17 in the placebo‐group developed oxygen desaturation, and one patient in the ketoprofen‐group developed bleeding at 5 h after surgery. Conclusions: Intravenous ketoprofen in adjunct to PCA morphine provided a significant opioid sparing effect and improved analgesia in children having chest wall correction surgery.