Author/Editor     Uranjek, Jasna; Rus-Vaupot, Viktorija
Title     Preemptivna analgezija z metamizolom pri bolnikih, operiranih zaradi manjših programskih operacij
Translated title     Pre-emptive analgesia with metamizol at the patients who were undergoing small, elective operations
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 69, št. 5
Publication year     2000
Volume     str. 353-6
Language     slo
Abstract     Background. An acute postoperative pain is still a major medical, economic and also societal problem. That is why so many studies are made, how to successfully prevent and treat post operative pain. Pre-emptive analgesia is one of the possibilities. The aim of our study was to evaluate the use of pre-emptive analgesia with metamizol intravenously with patients who were undergoing small, elective operations (stripping, removal of the osteosynthetic material, arthroscopy of the knee and sterilisation). Patients and methods. The study was accepted by the Republic Medical Ethical Commission. All included patients agreed with the participation in the study. 40 patients scheduled for minor operations were randomly assigned to group A and group B. Patients in group A received 2.5g metamizol intravenously 15 min. before induction to anaesthesia and group B received 2.5g metamizol at least 5 min. after surgical incision. Anaesthesia in both groups was maintained with the mixture of anaesthesiological gases 02:N20(50:50) and isofluorane or halothane. Preoperatively the patients were asked about their expectation of pain postoperatively, about their previous experiences of postoperative pain, preoperative use of analgesics and their subjective opinion about their pain threshold. Postoperatively, pain scores with visual analogue scale VAS (1-10), blood pressure, pulse and side effects were recorded every three hours for the first 24 hours after the surgery. Patients were told that they will get supplemental analgesic if the value of VAS was 4 or more. Results and discussion. VAS scores were statistically significant lower in group A (t = 2.9, p<O.O5; variances tested with F test) then in group B but in both groups they were in satisfying limits (VAS 1-3). Also the use of supplemental analgesics during and after the surgery was lower in group A. Conclusions. Both administrations of metamizol provide satisfying results. (Abstract truncated at 2000 characters.)
Summary     Izhodišča. Akutna pooperativna bolečina je še vedno velik medicinski, ekonomski in tudi socialni problem. Zato se izvaja veliko študij, kako jo čim učinkoviteje preprečiti in zdraviti. Preemptivna analgezija je ena od možnosti. Namen naše študije je bil oceniti preemptivno, intravensko uporabo metamizola pri bolnikih, operiranih zaradi manjših programskih operacij, kot so stripping, odstranitev osteosintetskega materiala, artroskopije kolena in sterilizacije. Bolniki in metode. Študijo je dovolila Republiška etična komisija. Vsi vključeni bolniki so se s sodelovanjem v študiji strinjali. 40 bolnikov, predvidenih za manjše programske operacije, smo randomizirano razporedili v skupini A in B. Bolniki v skupini A so prejeli 2,5g metamizola intravensko 15 minut pred indukcijo v anestezijo, bolniki v skupini B pa so prejeli 2,5g metamizola intravensko vsaj 5 minut po kirurškem rezu. Anestezijo smo v obeh skupinah vzdrževali z mešanico anestezijskih plinov 02:N20(50:50) in isofluoranom ali halothanom. Pred operacijo smo bolnike vprašali o pričakovanju bolečine po operaciji, o njihovih predhodnih izkušnjah s pooperativno bolečino, o uporabi analgetikov doma in o njihovem subjektivnem mnenju o lastnem pragu bolečine. Po operaciji smo vsake tri ure prvih 24 ur po operaciji ocenjevali bolečino s pomočjo vizualne analogne skale (VAS) z vrednostmi 1 do 10, merili krvni tlak, utrip in opazovali morebitne stranske učinke. Bolnikom smo povedali, da bodo dobili dodatne analgetike, ko bodo ocenili svojo bolečino z vrednostjo VAS 4 ali več. Rezultati in razpravljanje. Ocene VAS so bile statistično pomembno nižje v skupini A kot v skupini B (t = 2,9, p<0,05, variance testirane z F testom), vendar so bile v obeh skupinah v zadovoljivem območju VAS 1-3. Tudi poraba dodatnih analgetikov med in po operaciji je bila manjša v skupini A. (Izvleček prekinjen pri 2000 znakih.)
Descriptors     DIPYRONE
ANALGESIA
POSTOPERATIVE CARE
PREOPERATIVE CARE
ANALGESICS, NON-NARCOTIC
PAIN, POSTOPERATIVE