PREEMPTIVE KETOPROFEN FOR POSTOPERATIVE P AIN IN GYNECOLOGICAL SURGERY

Study objective: Ketoprofen exerts its clinical effect by inhibition o f prostaglandin synthesis, but also acts as an NMDA-receptor antagonis t by means of the kynurenic acid. Based on ketoprofen's supposed centr al mechanism of analgesia, we expected a preemptive effect, which was assessed by the present study. Methods: In a prospective, randomised, double-blind investigation of 48 patients undergoing gynaecological pr ocedures (la parotomy, pelvioscopy), the first group received ketoprof en 2 mg/kg body weight i.v. 20 min before the beginning of surgery and placebo i.v. at the end of surgery. In the second group, placebo was administered first and ketoprofen al the end of surgery. Premedication and anaesthesia were standardised by protocol. The postoperative anal gesic patient-controlled analgesia consumption by was also standardise d (piritramide). Efficacy was assessed by visual analogue scale (VAS) and total requirement of analgesics within the first 24 postoperative hours. The time to the first request for postoperative analgesics was also recorded. Safety was assessed by continous monitoring of vital pa rameters such as respiratory rate, heart rate, blood pressure, and oxy gen saturation. The incidence and severity of adverse events was docum ented. Results: There were no significant differences between the grou ps in demographic data or type or duration of surgery. The time to the first request for analgesic,VAS pain intensity, and analgesic consump tion in the first 24 h post-surgery were not significantly different b etween the groups (t-test). Conclusion: Ketoprofen is an effective pos toperative analgesic in combination with an opioid, but has no pre-emp tive effect according to the results of this study.