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Medicina Fluminensis : Medicina Fluminensis, Vol. 43. No. 3, 2007.

Professional paper

PERIOPERATIVE ANALGESIA WITH DICLOFENAK IN RECONSTRUCTIVE ACL SURGERY IN ATHLETES

Marina Barković ; Clinic for Orthopedics Lovran, School of medicine, University of Rijeka, Croatia
Igor Barković ; Department of Pulmology, Clinical hospital center Rijeka, Croatia
Branko Šestan ; Clinic for Orthopedics Lovran, School of medicine, University of Rijeka, Croatia
Mirjana Baričić ; Clinic for Orthopedics Lovran, School of medicine, University of Rijeka, Croatia
Kata Šakić ; Department of Anesthesiology, Clinical hospital center Zagreb, Croatia

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Abstract

SUMMARY
Objectives: Nonsteroidal antiinflammmatory drugs are
recommended for the multimodal analgetic management
of postoperative pain and may have significant
opioid-sparing effect after major surgery. Preemptive
analgesic efficacy of nonsteroidal antiinflammatory drug
diclofenac have not been evaluated after major orthopedic
surgery. This study was designed to determine
whether the administration of a preemptive doses of
diclofenac to patients who have undergone anterior cruciate
ligament reconstruction would enhance analgesia,
and/or decrease consumption of opioid analgetic fentanyl.
Patients and methods: We evaluated 80 patients undergoing
anterior cruciate ligament reconstruction. The
patients were divided into two groups: ones preemptively,
the night before and for 48 hr after operation,
received oral diclofenac and others placebo. All patients
postoperatively received combined intraarticular analgesia,
continious 24-hr intravenous infusion of 200 mg tramadolum and 2,5 g metamisolum and intravenous
fentanyl as needed. The outcome measures included
visual-analog pain scores at rest and movements preoperatively
and four times during 48 hours and the total
dose of fentanyl during 24 horus.
Results: The total dose of fentanyl were significantly less
in the diclofenac group, and pain scores were significantly
less in the diclofenac group at rest and movements
than in the control group (p<0,001).
Conclusion: Preemptive diclofenac demonstrated an
improved analgesic effect during 48 hours postoperatively.
Diclofenac can be reccommend as a preemptive
component of multimodal pain management in patients
undergoing anterior cruciate ligament reconstruction.

Keywords

anesthesia and analgesia; perioperative; preemptive; knee

Hrčak ID:

23420

URI

https://hrcak.srce.hr/23420

Publication date:

20.9.2007.

Article data in other languages: croatian

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