Intravenous paracetamol vs. ketoprofen for pain management after the abdominal aortic surgery – pharmacokinetics and therapeutics

10.20883/176 ◽  
2016 ◽  
Vol 85 (4) ◽  
pp. 254
Author(s):  
Jowita Rosada-Kurasińska ◽  
Alicja Bartkowska-Śniatkowska ◽  
Agnieszka Bienert ◽  
Małgorzata Grześkowiak ◽  
Paweł Sobczyński ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Postoperative Pain ◽  
Aortic Surgery ◽  
Venous Pressure ◽  
Intensive Therapy ◽  
University Hospital ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Intravenous Paracetamol ◽  
The Mean

Introduction. Acute postoperative pain continues to be a dilemma to patients and clinicians.Aim. To define the efficacy, tolerability and pharmacokinetics of paracetamol and ketoprofen in patients after the abdominal aortic surgery. Setting and design in University hospital – intensive therapy unit (clinical part), clinical pharmacy and biopharmacy unit (biochemical part), and pharmaceutical company (statistical part). Prospective randomized study.Material and Methods. 40 adult patients (50–84 years) undergoing abdominal aortic surgery were randomized equally into two groups. After extubation the patients in group 1 (G1) were administered a 1 g paracetamol infusion, and in group 2 (G2) – a 100 mg ketoprofen infusion, both within 15 minutes. All the patients received an epidural infusion of bupivacaine with fentanyl. The following parameters were recorded: mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), plasma concentration of paracetamol and ketoprofen. Postoperative pain was assessed with the visual analogue scale (VAS).Results. The mean values of the MAP, HR and CVP were within normal limits in the both groups. No significant differences were noticed in the assessment of postoperative pain and total use of an opioid. The mean therapeutic plasma concentration of paracetamol and ketoprofen remained up to 180 minutes and up to 120 minutes, respecively.Conclusions. The study enabled us to conclude that intravenous paracetamol as well as ketoprofen have good effectiveness and tolerability. There is no need to modify dosage of these drugs to elderly patients. After paracetamol infusion the therapeutic plasma concentration remains longer than after the ketoprofen infusion.

scholarly journals Intravenous paracetamol vs. ketoprofen for pain management after the abdominal aortic surgery – pharmacokinetics and therapeutics

2016 ◽  
Vol 85 (4) ◽  
pp. 254-263
Author(s):  
Jowita Rosada-Kurasińska ◽  
Alicja Bartkowska-Śniatkowska ◽  
Agnieszka Bienert ◽  
Małgorzata Grześkowiak ◽  
Paweł Sobczyński ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Postoperative Pain ◽  
Aortic Surgery ◽  
Venous Pressure ◽  
Intensive Therapy ◽  
University Hospital ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Intravenous Paracetamol ◽  
The Mean

Introduction. Acute postoperative pain continues to be a dilemma to patients and clinicians.Aim. To define the efficacy, tolerability and pharmacokinetics of paracetamol and ketoprofen in patients after the abdominal aortic surgery. Setting and design in University hospital – intensive therapy unit (clinical part), clinical pharmacy and biopharmacy unit (biochemical part), and pharmaceutical company (statistical part). Prospective randomized study.Material and Methods. 40 adult patients (50–84 years) undergoing abdominal aortic surgery were randomized equally into two groups. After extubation the patients in group 1 (G1) were administered a 1 g paracetamol infusion, and in group 2 (G2) – a 100 mg ketoprofen infusion, both within 15 minutes. All the patients received an epidural infusion of bupivacaine with fentanyl. The following parameters were recorded: mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), plasma concentration of paracetamol and ketoprofen. Postoperative pain was assessed with the visual analogue scale (VAS).Results. The mean values of the MAP, HR and CVP were within normal limits in the both groups. No significant differences were noticed in the assessment of postoperative pain and total use of an opioid. The mean therapeutic plasma concentration of paracetamol and ketoprofen remained up to 180 minutes and up to 120 minutes, respecively.Conclusions. The study enabled us to conclude that intravenous paracetamol as well as ketoprofen have good effectiveness and tolerability. There is no need to modify dosage of these drugs to elderly patients. After paracetamol infusion the therapeutic plasma concentration remains longer than after the ketoprofen infusion.

Early and Delayed Myocardial Infarction after Abdominal Aortic Surgery

2005 ◽  
Vol 102 (5) ◽  
pp. 885-891 ◽  
Author(s):  
Yannick Le Manach ◽  
Azriel Perel ◽  
Pierre Coriat ◽  
Gilles Godet ◽  
Michèle Bertrand ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Aortic Surgery ◽  
Myocardial Damage ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Rate Of Increase ◽  
Postoperative Myocardial Infarction ◽  
The Mean ◽  
Mean Time

Background Although postoperative myocardial infarction (PMI) after vascular surgery has been described to be associated with prolonged ischemia, its exact pathophysiology remains unclear. Methods The authors used intense cardiac troponin I (cTnI) surveillance after abdominal aortic surgery in 1,136 consecutive patients to better evaluate the incidence and timing of PMI (cTnI > or = 1.5 ng/ml) or myocardial damage (abnormal cTnI < 1.5 ng/ml). Results Abnormal cTnI concentrations was noted in 163 patients (14%), of which 106 (9%) had myocardial damage and 57 (5%) had PMI. In 34 patients (3%), PMI was preceded by a prolonged (> 24 h) period of increased cTnI (delayed PMI), and in 21 patients (2%), the increase in cTnI lasted less than 24 h (early PMI). The mean times from end of surgery to PMI were 37 +/- 22 and 74 +/- 39 h in the early PMI and delayed PMI groups, respectively (P < 0.001). The mean time between the first abnormal cTnI and PMI in the delayed PMI group was 54 +/- 35 h, during which the cTnI profiles of the myocardial damage and delayed PMI groups were identical. In-hospital mortality rates were 24, 21, 7, and 3% for the early PMI, delayed PMI, myocardial damage, and normal groups, respectively. Conclusions Intense postoperative cTnI surveillance revealed two types of PMI according to time of appearance and rate of increase in cTnI. The identification of early and delayed PMI may be suggestive of different pathophysiologic mechanisms. Abnormal but low postoperative cTnI is associated with increased mortality and may lead to delayed PMI.

Continuous Elastomeric Pump-Based Ropivacaine Wound Instillation after Open Abdominal Aortic Surgery: How Reliable Is the Technique?

2011 ◽  
Vol 14 (1) ◽  
pp. 51 ◽  
Author(s):  
Werner Baulig ◽  
Konrad Maurer ◽  
Oliver Michel Theusinger ◽  
Valentin Hinselmann ◽  
Barbara Baulig ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Aortic Surgery ◽  
Plasma Concentrations ◽  
Control Group ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic ◽  
Morphine Administration ◽  
Surgical Data ◽  
The Impact

Introduction: We aimed at quantifying the impact of continuous wound infusion with ropivacaine 0.33% on morphine administration and subjective pain relief in patients after open abdominal aortic repair in a double-blind, placebo-controlled study.Methods: Before closing the abdominal wound, 2 multihole ON-Q Soaker Catheters (I-Flow Corporation, Lake Forest, California, USA) were placed pre-peritoneally in opposite directions. Either ropivacaine 0.33% or saline 0.9% was delivered by an elastomeric pump at a rate of 2 mL/h for 72 hours in each of the catheters. Postoperative pain and morphine administration were assessed using the numerical rating scale (NRS) in 4-hour intervals. Total plasma concentrations of ropivacaine, unbound ropivacaine, and 1-acid glycoprotein (AAG) were measured daily. Mean arterial pressure, pulse rate, oxygen saturation, total amount of morphine administration, ventilation time, and length of stay in the intensive care unit (ICU) were recorded. At the end of the study period, the wound site and the condition of the catheters were assessed.Results: The study was terminated prematurely due to a malfunction of the elastomeric balloon pump resulting in toxic serum levels of total ropivacaine in 2 patients (11.4 mol/L and 10.0 mol/L, respectively) on the second postoperative day. Six patients had been allocated to the ropivacaine group, and 9 patients had been allocated to the control group. Demographic and surgical data were similar in both groups. During the first 3 postoperative days, no difference between the ropivacaine and the control group was found in NRS (P = .15, P = .46, and P = .88, respectively) and morphine administration (P = .48). Concentrations of unbound serum ropivacaine (0.11 0.08 mol/L) were below toxic level in all patients.Conclusion: Continuous wound infusion of ropivacaine 0.33% 2 mL/h using an elastomeric system was not reliable and did not improve postoperative pain control in patients after open abdominal aortic surgery.

Incidence and circumstances of serum creatinine increase after abdominal aortic surgery

2003 ◽  
Vol 29 (10) ◽  
pp. 1821-1824 ◽  
Author(s):  
Frédérique Ryckwaert ◽  
Pierre Alric ◽  
Marie-Christine Picot ◽  
Kela Djoufelkit ◽  
Pascal Colson
Keyword(s):  
Serum Creatinine ◽  
Aortic Surgery ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic

A Double-blind Protocol Comparing Regional and General Anesthetic Techniques during Abdominal Aortic Surgery

1994 ◽  
Vol 81 (SUPPLEMENT) ◽  
pp. A65
Author(s):  
R. B. Gorman ◽  
EJ. Norris ◽  
MJ. Breslow ◽  
JA. Grass ◽  
C. Beattie
Keyword(s):  
Aortic Surgery ◽  
Anesthetic Techniques ◽  
General Anesthetic ◽  
Double Blind ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic
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