Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia
Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.
Rosenquist RW, Vrooman MS. Chronic Pain Management. In: Morgan & Mikhail’s Clinical Anesthesiologist. Lange 5th editions. 2013; 1023- 1035.
Thomas J. Practical Perioperative Pain Control in Children and Adults. Southern African J of Anesthesia and Analgesia. 2008; 14(6): 11- 17.
Koh W, Pham KN, Jahr JS. Intravenous Non-Opioid Analgesia for Peri- and Postoperative Pain Management: a Scientific Review of Intravenous Acetaminophen and Ibuprofen. Korean J of Anest February. 2015; 68 (1): 3-12.
Trotter MJ, Perioperative Pain Management Chapter 47. www.podiatryinstitute.com. 2013;
Mishra AK, Afzal M, Mookerjee S, et al. Review Article: Pre-emptive Analgesia: Recent Trends and Evidence. 2013; 27: 114- 120.
Stoelting, Robert K, Hilier, Simon C. Handbook of Pharmacology and Physiology in Anesthetic Practice. Lippincott Williams & Wilkins.2006;
Kokki H, Karvinen M, Suhonen M. Pharmacokinetics of Intravenous and Rectal ketoprofen in Young Children. Original Research Article, Clinical Pharmacokinetics. 2003; 42(4): 373-379.
Cavalcanti IL, Carvalho AC, Musauer MG, et al. Safety and Tolerability of Controlled – Released Oxycodone on Postoperative Pain in Patient submitted to the Oncologic Head and Neck Surgery. Rev. Col. Bras. 2014; 41 (6): 393-399.
Mc Cartney CJ, Niazi C. Use of Opioid Analgesics in the Perioperative Period. In: Postoperative Pain Management: An Evidence-Based Guided to Practice. 2006; Chapter 15: 137-139.
Barash PG, Cullen BF, Stoelting RK. Opioids. In: Clinical Anaesthesia. 5th edition. Lippincott Williams and Wilkins. 2006; Chapter 14: 354- 364.
Fukuda H. Opioids. In: Miller R.D. Miller’s Anesthesia. Seventh editions. Churcil Livingstone Elsevier. 2007; Chapter 27: 769–789.
Barash PG, Cullen BF, Stoelting RK. Opioids. In: Handbook of Clinical Anesthesia, 6th editions, Lippincott Williams and Wilkins. 2009; Chapter 19: 270-280.
Indonesian Journal of Anesthesiology and Reanimation (IJAR) licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. Copyright holder is the author.
2. The journal allows the author to share (copy and redistribute) and adapt (remix, transform, and build) upon the works under license without restrictions.
3. The journal allows the author to retain publishing rights without restrictions.
4. The changed works must be available under the same, similar, or compatible license as the original.
5. The journal is not responsible for copyright violations against the requirement as mentioned above.