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Analgesia preventiva: ketoprofeno-levobupivacaina en colecistectomía laparoscopica comparada con el efecto de su administración postoperatoria

Abstract:

Introduction: 84% of patients have postoperative pain, there is not a consensus control, and the preemptive analgesia (PA) is an interesting alternative. Objective: To determine the analgesic efficacy of levobupivacaine – ketoprofen combination administered before the nociceptive stimulus (preoperative) compared with post laparoscopic cholecystectomy administration (after surgery), Homer Castanier Hospital. Methods: A randomized clinical trial single-blind was conducted, 100 patients into two groups are divided, 50 received preoperative ketoprofen – levobupivacaine combination (experimental group) and 50 received the same combination in the postoperative period (control group), to measure the intervention effectiveness the pain intensity was assessed -using the Visual Analogue Scale (VAS)- and additional analgesic requirements postoperatively. The analysis was performed using chi-square test and Student t test. The P value p<0.05 was considered significant. Results: Both groups were comparable (p>0.05). Experimental group had a lower postoperative pain intensity than control group at first 24 hours (p <0.05), after 24 hours the difference was not significant (p=0.063); The PA provided a lower risk of postoperative pain with RR=0,313 and ITT=2.27. The average supplemental analgesics doses are used was significantly higher in the control group 2.3 ± 1.03 than the experimental group 1.2 ± 0.72 (p <0.05), but the PA did not eliminate need for additional analgesia. Conclusions: Ketoprofen + levobupivacaine combination was effective, pain intensity decreased and the additional analgesics doses postoperatively were lower too, but did not eliminate the need for additional analgesia.