Is the effect of inguinal field block with 0.5% bupivacaine on postoperative pain after hernia repair enhanced by addition of ketorolac or S(+) ketamine?

Détails

ID Serval
serval:BIB_EEA16ABD914A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Is the effect of inguinal field block with 0.5% bupivacaine on postoperative pain after hernia repair enhanced by addition of ketorolac or S(+) ketamine?
Périodique
Clinical Journal of Pain
Auteur(s)
Clerc  S., Vuilleumier  H., Frascarolo  P., Spahn  D. R., Gardaz  J. P.
ISSN
0749-8047 (Print)
Statut éditorial
Publié
Date de publication
02/2005
Volume
21
Numéro
1
Pages
101-5
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Jan-Feb
Résumé
OBJECTIVE: The aim of the study was to assess whether coadministration of S(+) ketamine or ketorolac would enhance or prolong local analgesic effect of bupivacaine after inguinal hernia repair. DESIGN: Prospective double-blind randomized study evaluating pain intensity after surgery under general anesthesia. SETTING: Outpatient facilities of the University Hospital of Lausanne. PATIENT: Thirty-six ASA I-II outpatients scheduled for elective day-case inguinal herniorraphy. INTERVENTION: Analgesia strategy consisted of a wound infiltration and an inguinal field block either with 30 mL bupivacaine (0.5%) or with the same volume of a mixture of 27 mL bupivacaine (0.5%) + 3 mL S(+) ketamine (75 mg) or a 28 mL bupivacaine (0.5%) + 2 mL ketorolac (60 mg). Postoperative analgesic regimen was standardized. OUTCOME MEASURES: Pain intensity was assessed with a Visual Analog Scale, a verbal rating score, and by pressure algometry 2, 4, 6, 24, and 48 hours after surgery. RESULTS: The 3 groups of patients experienced the highest Visual Analog Scale pain score at 24 hours, which was different from those at 6 and 48 hours (P < 0.05). Apart from a significantly lower pain sensation (verbal rating score) in the ketorolac group at 24 and 48 hours and only at 48 hours with ketamine, there were no other differences in pain scores, pain pressure thresholds, or rescue analgesic consumption between groups throughout the 48-hour study period. CONCLUSION: The addition of S(+)-ketamine or ketorolac only minimally improves the analgesic effect of bupivacaine. This may be related to the tension-free hernia repair technique associated with low postoperative pain.
Mots-clé
Adult Anesthetics, Dissociative/adverse effects/*therapeutic use *Anesthetics, Local/adverse effects Anti-Inflammatory Agents, Non-Steroidal/adverse effects/*therapeutic use *Bupivacaine/adverse effects Double-Blind Method Female Hernia, Inguinal/*surgery Humans Ketamine/adverse effects/*therapeutic use Ketorolac/adverse effects/*therapeutic use Male Middle Aged *Nerve Block Pain Measurement Pain, Postoperative/*drug therapy Prospective Studies
Pubmed
Web of science
Création de la notice
28/01/2008 11:48
Dernière modification de la notice
03/03/2018 22:33
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