COMPARISON OF PARENTERAL DICLOFENAC AND KETOPROFEN FOR POSTOPERATIVE PAIN RELIEF AFTER MAXILLOFACIAL SURGERY

Non-steroidal anti-inflammatory drugs (NSAID) effectively reduce the n eed for opioid analgesia after various types of surgery. The efficacy of diclofenac and ketoprofen to relieve pain after maxillofacial surge ry was compared in the present study. In a randomized and double-blind fashion, 90 ASA I-II patients (16-60 yrs) were studied. divided into three groups: Thirty patients received 1.0 mg.kg(-1) diclofenac i.v. a fter general anaesthesia induction, before surgical incision, and four hours later the same dose was given i.m. Thirty patients received ket oprofen 1.35 mg.kg(-1) i.v. and i.m., as above, and a third group of 3 0 patients received a comparable volume of saline i.v. and i.m. The pa tients received supplemental analgesia using a patient controlled anal gesia apparatus; the rescue medication consisted of 0.03 mg.kg(-1) oxy codone i.v. (four-hour maximum dose was 0.4 mg.kg(-1)) during the 24-h our follow-up. The three groups were comparable regarding the type of maxillofacial surgery) (osteotomies vs. soft tissue surgery. Overall, there was a lower need for i.v. oxycodone during the 21-hour period in the diclofenac group (269 doses) than in the ketoprofen group and in the saline group (388 doses, each) (P<0.01). The significantly lower n umber of oxycodone administrations in the diclofenac group was a resul t of a distinguishable difference, particularly during the first four hours after surgery. There was no statistically significant difference in the incidence of side effects of the analgesic therapy between the three groups.