Abstract:

Objectives: The aim of this prospective randomized, double-blind study was to evaluate the analgesic efficacy and opioid-sparing effects of preemptive single dose of dexketoprofen trometamol, in comparison with that of paracetamol or placebo, for elective lumbar disc surgery, over a 24 h investigation period. Methods: After institutional approval and informed consent had been obtained, 75 patients scheduled for single level lumbar disc surgery were randomly allocated into three equal groups. Patients received oral dexketoprofen 25 mg (group D), 500 mg paracetamol (group P) or placebo tablets (group C) 30 min before induction of standard anesthesia. Patient-controlled analgesia was supplied postoperatively using morphine. Hemodynamics, visual analog scale (VAS), sedation score, morphine consumption and side effects were recorded at every 15 min in the first hour, and 2, 6 and 24 h after surgery. Results: The mean pain scores were similar among groups (p>0.05). The cumulative (SD) 24-hour morphine consumption was 28.1 mg, 40.6 mg, and 43.6 mg for groups D, P and C, respectively. The amount of morphine use at 2, 6 and 24 h was significantly lower in Group D (p<0,006). Hemodynamic parameters, sedation scores and side-effects did not differ among the groups (p>0.05). Conclusion: The study demonstrates preemptive dexketoprofen trometamol 25 mg is associated with a decrease of up to 35% in morphine consumption compared with placebo over 24 hours following lumbar disc surgery, however, paracetamol 500 mg does not show an expected opioid sparing effect comparatively.

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