مقایسه اثرپیشگیرانه ایبوپروفن و کتورولاک وریدی در کنترل درد بعد از اعمال جراحی اندام فوقانی: یک مطالعه کارآزمایی بالینی تصادفی شده دو سویه کور

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار گروه بیهوشی، فلوشیپ مراقبت های ویژه، مرکز تحقیقات بیهوشی، مراقب تهای ویژه و کنترل درد، دانشگاه علوم پزشکی هرمزگان، بندرعباس،

2 استادیار بیهوشی، فلوشیپ مراقبتهای ویژه، مرکز تحقیقات بیهوشی، مراقبتهای ویژه و کنترل درد، دانشگاه علوم پزشکی هرمزگان، بندر عباس، ایران.

چکیده

مقدمه: درد بعد از اعمال جراحی یک تجربه ی ناخوشایند است. این فرایند باعث می شود اختلالات فیزیولوژیک در تمام سیستم های بدن بوجود آید. ضد التهاب های غیراستروئیدی از جمله داروهای پرکاربرد جهت کنترل درد بعد از عمل می باشند. لذا این مطالعه با هدف مقایسه اثرپیشگیرانه ایبوپروفن وریدی و کتورولاک وریدی در کنترل درد بعد از اعمال جراحی اندام فوقانی انجام شد.
روش کار: در این مطالعه کارآزمایی بالینی تصادفی شده دو سویه کور 60 بیمار با کلاس بیهوشی I و  II تحت عمل جراحی ارتوپدی اندام فوقانی قرار گرفتند. بیماران به صورت تصادفی به دو گروه ایبوبروفن وریدی و کتورولاک تقسیم شدند. فشار خون سیستول و دیاستول، فشار متوسط شریانی و ضربان قلب قبل از عمل، 1، 10 و 20 دقیقه بعد از عمل ثبت شد. میزان درد قبل از عمل، 6، 12 و 24 ساعت پس از عمل انداره گیری شد. تجزیه و تحلیل اطلاعات با استفاده از نرم افزار SPSS نسخه 21 و با استفاده از آزمون های آماری توصیفی و استنباطی صورت گرفت.
نتایج: گروه‌های ایبوبروفن و کتورولاک از لحاظ جنسیت، سنی، شاخص توده بدنی و کلاس بیهوشی همسان بودند. نتایج آزمون من ویتنی نشان داد که بین گروه‌های ایبوپروفن و کتورولاک از لحاظ درد در زمان‌ 6 ساعت بعد از عمل تفاوت معنی‌دار وجود داشت (p<0.05). در 6 ساعت بعد از عمل، میانگین درد در بیماران گروه  ایبوپروفن بالاتر از گروه کتورولاک بوده است. همچنین نتایج آزمون فریدمن نشان داد که روند درد در گروه‌های کتورولاک و ایبوپروفن معنی‌دار بود (p<0.05).  نتیجه گیری: بر اساس نتایج حاصل از مطالعه حاضر تزریق 30 میلی گرم کتورلاک داخل وریدی نسبت به 400 میلی گرم ایبوبروفن کاهش درد بیشتری را در طول مطالعه به خصوص در 6 ساعت اول پس از عمل در بین بیماران تحت عمل جراحی ارتوپدی اندام فوقانی داشته است.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of the prophylactic effect of ibuprofen and intravenous ketorolac in pain control after upper extremity surgery: A Double-Blind Randomized Clinical Trial Study

نویسندگان [English]

  • Majid Vatankhah 1
  • Mehrdad Melekshoar 2
1 Assistant Professor of Anesthesiology, Intensive Care fellowship, Anesthesiology &amp;amp; Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2 Associated Professor of Anesthesiology, Cardiothoracic anesthesia fellowship, Anesthesiology &amp; Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
چکیده [English]

Introduction: Pain after surgery is an unpleasant experience. This process causes physiological disorders in all systems of the body. Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs to control postoperative pain. Therefore, this study was performed to compare the prophylactic effect of intravenous ibuprofen and intravenous ketorolac in pain control after upper extremity surgery. Methods: In this randomized double-blind clinical trial study, 60 patients with anesthesia class I and II underwent upper limb orthopedic surgery. Patients were randomly divided into intravenous ibuprofen and ketorolac. Systolic and diastolic blood pressure, mean arterial pressure and heart rate before surgery, 1, 10 and 20 minutes postoperatively were recorded. Pain was measured before, 6, 12 and 24 hours after surgery. Data analysis was performed using SPSS software version 21 and using descriptive and inferential statistical tests.
Results: Ibuprofen and ketorolac groups were similar in terms of gender, age, BMI and ASA. The results of Mann-Whitney test showed that there was a significant difference between ibuprofen and ketorolac groups in terms of pain at 6 hours postoperatively (p <0.05). At 6 hours postoperatively, the mean pain in patients in the ibuprofen group was higher than in the ketorolac group. Also, the results of Friedman test showed that the pain trend was significant in the ketorolac and ibuprofen groups (p <0.05).
Conclusion: Based on the results of the present study, injection of 30 mg intravenous ketorolac had more pain relief than 400 mg ibuprofen during the study, especially in the first 6 hours after surgery among patients undergoing upper limb orthopedic surgery. 

کلیدواژه‌ها [English]

  • Intravenous Ibuprofen
  • Ketorolac
  • Pain
  • Orthopedics
  • Upper limb

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 64، شماره 2
خرداد و تیر 1400
صفحه 2692-2705

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