Author/Authors :
Jahangiri Fard، Alireza نويسنده Anesthesiologist, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) ,Shahid Beheshti University of Medical Science, Tehran, Iran , , Farzanegan، Behrooz نويسنده Chronic Respiratory Disease Research Center, NRITLD, Shahid Beheshti University M.C., TEHRAN-IRAN. , , Khalili، Ali نويسنده is full professor of structural engineering in Department of Civil at Semnan University, Iran. , , Ebrahimi Ahmadabad، Nejatali نويسنده Anesthesiology Research Center, Masih Daneshvari Hospital,
Shahid Beheshti University of Medical Sciences, Tehran,
Iran , , Daneshvar Kakhaki ، Abolghasem نويسنده Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) , , Parsa، Tahereh نويسنده , , Mahjoobifard، Maziyar نويسنده Children and Adolescent Health Research Center,
Ali-Ebne-Abitaleb Hospital, Zahedan University of Medical Sciences,
Zahedan, Iran , , Khabiri، Mohammad نويسنده Faculty Members of Physical Education and Sport Sciences Faculty, University of Tehran, Tehran , , Golestani Eraghi، Majid نويسنده Fellowship of Intensive Care, Department of Anesthesiology, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran ,
Abstract :
Video-assisted thoracic surgery (VATS) is a minimally invasive
procedure that is growing more common around the world. Despite causing
less pain compared open thoracic surgery, postoperative pain management
is still important. The aim of the present study was to compare the
analgesic effects of paracetamol and ketorolac in VATS patients. This
was a double-blinded randomized clinical trial conducted on 70 patients
undergoing lobectomy or segmentectomy due to lung masses, using
video-assisted methods. The patients were randomly divided into two
groups (each n = 35): the ketorolac (K) group and the paracetamol (P)
group. The K group received ketorolac 30 mg IV stat at the end of
surgery and then a 90 mg/24 h infusion. The P group received paracetamol
1 g IV stat at the end of surgery and then a 3 g/24 h infusion. Pain
scores were recorded during recovery and 2, 4, 8, 12, and 24 hours after
drug administration. Pain scores, total doses of rescue analgesics, and
patient satisfaction levels were compared between the groups. There was
no significant difference between the K and P groups in pain scores in
any of the evaluations. Seventeen (48.6 %) and 9 (25.7 %) patients in
the K and P groups, respectively, did not require any rescue analgesia
(P = 0.047). The mean doses of rescue analgesia in the K and P groups
were 3.129 ± 4.27 mg and 4.38 ± 3.69 mg, respectively, which were
similar (P = 0.144). There was no significant difference between the
groups in satisfaction scores (P = 0.175). Paracetamol 1 g stat + 3 g/24
h infusion is as effective as ketorolac 30 mg stat + 90 mg/24 h infusion
in post-VATS pain management, with good tolerability and a low incidence
of adverse effects.
