Korean J Pain.  2014 Oct;27(4):345-352. 10.3344/kjp.2014.27.4.345.

Analgesia after Epidural Dexamethasone is Further Enhanced by IV Dipyrone, but Not IV Parecoxibe Following Minor Orthopedic Surgery

• Lauretti G
• Righeti CC
• Kitayama A

• KMID: 1802501
• DOI: http://doi.org/10.3344/kjp.2014.27.4.345

Abstract

BACKGROUND
Epidural administration of dexamethasone has been suggested for pain control after minor orthopedic surgery. This study was conducted to assess its efficacy after such surgery, combined or not to IV dipyrone, IV parecoxibe or their combination.
METHODS
91 patients were randomly assigned to seven groups. Patients were submitted to spinal bupivacaine anesthesia combined to epidural administration of either 10 ml saline or 10 mg dexamethasone diluted to 10-ml volume. Patients also received 10 ml IV saline or 1 gr dipyrone and/or 40 mg parecoxibe diluted to 10 ml with saline. Control group (CG) received epidural and IV saline. Dexamethasone group (DexG) received epidural dexamethasone and IV saline. Dipyrone group (DipG) received epidural saline and IV dipyrone. Dex-Dip G received epidural dexamethasone and IV dipyrone. Parecoxibe group (ParG) received epidural saline and IV parecoxibe. Dex-ParG received epidural dexamethasone and IV parecoxibe. Finally, Dex-Dip-ParG received epidural dexamethasone and IV dipyrone plus IV parecoxibe.
RESULTS
The CG expressed 4h of analgesia and sooner requested pain killer. DexG was similar to DipG or ParG or Dex-ParG (7-hours), and they requested less ketoprofen compared to the CG (P < 0.05). However, the Dex-DipG and the Dex-Dip-ParG resulted in longer time to demand pain killer (17-hours) and less ketoprofen consumption in 24-hours (P < 0.002). Adverse effects were similar among groups.
CONCLUSIONS
The analgesia secondary to epidural dexamethasone was enhanced by IV dipyrone, while no effects were observed by the addition of IV parecoxibe.

Keyword

epidural dexamethasone; orthopedic surgery; postoperative pain; IV dipyrone; IV parecoxibe

MeSH Terms

Analgesia*
Anesthesia
Bupivacaine
Dexamethasone*
Dipyrone*
Humans
Ketoprofen
Orthopedics*
Pain, Postoperative
Bupivacaine
Dexamethasone
Dipyrone
Ketoprofen

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