2003, Number 1
<< Back Next >>
Cir Cir 2003; 71 (1)
Ketorolac vs metamizol preemptive analgesia in children
Peñuelas-Acuña J, Oriol-López SA, Hernández-Bernal CE, Castelazo-Arredondo JA
Language: Spanish
References: 17
Page: 50-54
PDF size: 52.58 Kb.
ABSTRACT
Preventive analgesia produced by ketorolac and metamizol was
evaluated during a prospective study randomized in two groups. One
hundred twenty children were included aged from 3 to 6, years who
underwent surgery by different procedures. Analgesic dose was
applied 15 min prior to surgery by intravenous (i.v.) via.
Technique used was inhaled general anesthesia; use of opioids was
avoided. Pain evaluation at the end of surgery (and during the
following 48 to 72 h) as well as bleeding time, platelet count,
and alterations in white blood cell count were dependent variables.
As soon as patients arrived in the recovery room, pain was measured
by modified McGrath scales and the chromatic EVA. In ketorolac
group, 40% of children showed no pain and 55% presented mild to
moderate pain (1-6). In metamizol group, 40% of children referred
no pain, while 55% evaluated pain as minimal to moderate. Analgesia
produced by both drugs presented no significant statistical
diference (p > 0.5). Troughout follow-up, maximum pain referred had
a values of 6 and 7, respectively, for ketorolac and metamizol.
Fifteen min after analgesic dose, pain was referred as 3 and 4.
No alterations were observed in bleeding time, platelet count, and
white blood cell count. We conclude that both analgesics prevent
hyperalgesia during post-surgical period.
REFERENCES
Cruz M. Fundamentos actuales de la terapéutica del dolor en pediatría. Bol Pediatr 1999;39:186-196.
Joele F, Desparmet-S. Dolor en la infancia. Ch. 21. In: Prithvi R, editor. El tratamiento práctico del dolor. 2nd ed. Mosby Year Book; 1994.
Narinder R. Dolor postoperatorio y su tratamiento. Ch. 22. In: Prithvi R, editor. El tratamiento práctico del dolor. 2nd ed. Edit Mosby Year Book; 1994.
Kissin I. Preemptive analgesia: why its effect is not always obvious (Editorial view). Anesthesiology 1996;84(5):1015-1019.
Analgésicos antiinflamatorios, el cuidado de su uso. Segundo Foro Nacional de Farmacovigilancia. Academia Nacional de Medicina. Agosto 2001. File:// A:analgésicos antiinflamatorios, el cuidado de su uso.htm
Brooks PM, Day RQ. No steroideal anti-inflammatory drug differences and similarities. N Engl J Med 1991;13:324.
Jane C, Gillis y Rex NB. Ketorolaco: reevaluación de las propiedades farmacodinámicas y farmacocinéticas, y uso terapéutico en el tratamiento del dolor. Drugs 1997;53(1):139-188.
Dsida RM, Wheeler M, Birmingham PK. Age-stratified pharmacokinetics of ketorolac Trometamine in pediatric surgical patients. Anesth Analg 2002;94:266-270.
Ceraso OL. Los analgésicos antitérmicos. Ch. 4. Edit. López Libreros; Buenos Aires, Argentina;1994.
Dipirona, farmacocinecia y farmacodinamia. Micromedix 1994-1998, Inc. Vol. 95.
Levy M, Zylver-Katz E, Rosenkranz B. Clinical pharmacokinetics of dipirona and its metabolites. Clin Pharmacokinet 1995;28(3): 216-234.
Morton NS. Prevention and control of pain in children. B J Anaesth 1999;83:118-129.
McGraph PA, deVeber L, Hearn M: Multidimensional pain assessment in children. In: Fields H, Dubner R, Cervero F, editors. Advances in pain research and therapy. New York: Raven Press;1985.pp.387-393.
Van Dijk M. Postoperative pain assessment in neonates and infant: state of the art. Pediatric Pain Lett October 2001;5:437-438.
Chambers CT, Reid GJ, Craig KD, McGrath PJ. Agreement between child and parent reports of pain. Clin J Pain 1998;14:336-342.
Steen M, Kehlet H, Dahl JBerg. A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology 2002;96(3):725-741.
Kissin I. Preemptive analgesia. Anesthesiology 2000;3(4):1138-1143.