A randomized, double blind comparison of pethidine and ketoprofen as adjuvants for lignocaine in intravenous regional anaesthesia

• Published in: Brazilian journal of anesthesiology (Elsevier) 2014-07, Vol.64 (4), p.221-226
• Main Authors: Desai, Sameer N., Santhosh, M.C.B.
• Format: Article
• Language: English
• Subjects: Adjuvants, Anesthesia - administration & dosage; Adjuvants, Anesthesia - adverse effects; Adolescent; Adult; Anestesia regional intravenosa; Anesthesia, Conduction - adverse effects; Anesthesia, Conduction - methods; Anesthesia, Intravenous - adverse effects; Anesthesia, Intravenous - methods; ANESTHESIOLOGY; Anesthetics, Local - administration & dosage; Anesthetics, Local - adverse effects; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Cetoprofeno; Diclofenac - administration & dosage; Double-Blind Method; Female; Fentanyl - administration & dosage; Humans; Intravenous regional anaesthesia; Ketoprofen; Ketoprofen - administration & dosage; Ketoprofen - adverse effects; Ketoprofeno; Lidocaine - administration & dosage; Lidocaine - adverse effects; Male; Meperidine - administration & dosage; Meperidine - adverse effects; Middle Aged; Pain Measurement; Pain, Postoperative - prevention & control; Pethidine; Petidina; Prospective Studies; Time Factors; Young Adult
• ISSN: 0104-0014; 1806-907X; 0104-0014
• DOI: 10.1016/j.bjane.2013.03.016

A review of all the adjuncts for intravenous regional anaesthesia concluded that there is good evidence to recommend NonSteroidal Anti-Inflammatory agents and pethidine in the dose of 30mg dose as adjuncts to intravenous regional anaesthesia. But there are no studies to compare pethidine of 30mg dose to any of the NonSteroidal Anti-Inflammatory agents. In a prospective, randomized, double blind study, 45 patients were given intravenous regional anaesthesia with either lignocaine alone or lignocaine with pethidine 30mg or lignocaine with ketprofen 100mg. Fentanyl was used as rescue analgesic during surgery. For the first 6h of postoperative period analgesia was provided by fentanyl injection and between 6 and 24h analgesia was provided by diclofenac tablets. Visual analogue scores for pain and consumption of fentanyl and diclofenac were compared. The block was inadequate for one case each in lignocaine group and pethidine group, so general anaesthesia was provided. Time for the first dose of fentanyl required for postoperative analgesia was significantly more in pethidine and ketoprofen groups compared to lignocaine group (156.7±148.8 and 153.0±106.0 vs. 52.1±52.4min respectively). Total fentanyl consumption in first 6h of postoperative period was less in pethidine and ketoprofen groups compared to lignocaine group (37.5±29.0mcg, 38.3±20.8mcg vs. 64.2±27.2mcg respectively). Consumption of diclofenac tablets was 2.4±0.7, 2.5±0.5 and 2.0±0.7 in the control, pethidine and ketoprofen group respectively, which was statistically not significant. Side effects were not significantly different between the groups. Both pethidine and ketoprofen are equally effective in providing postoperative analgesia up to 6h, without significant difference in the side effects and none of the adjuncts provide significant analgesia after 6h. uma revisão de todos os adjuvantes para anestesia regional intravenosa concluiu que há boas evidências para recomendar os agentes anti-inflamatórios não esteroides e petidina em dose de 30mg como adjuvantes para anestesia regional intravenosa. Porém, não há estudos que comparem petidina (30mg) com quaisquer dos agentes anti-inflamatórios não esteroides. em um estudo prospectivo, randômico e duplo-cego, 45 pacientes receberam anestesia regional intravenosa com apenas lidocaína ou lidocaína com petidina (30mg) ou lidocaína com cetoprofeno (100mg). Fentanil foi usado como analgésico de resgate durante a cirurgia. Durante as seis primeiras horas de p