Comparison of the effects of dexketoprofen application before the operation or before the end of the operation on postoperative pain in nasal surgery.

Background: Postoperative analgesia is important because it prevents the adverse effects of pain. But it have been emphasized that postoperative analgesia’s timing is important in studies. Objective: To study the effect of preoperative or intraoperative intravenous application of dexketoprofen on postoperative analgesia and patient comfort in patients undergoing septorhinoplasty. Methods: A randomized, double-blind, placebo-controlled study. The study included 100 patients with ASA status I-II, 18-60 years old, scheduled for septorhinoplasty in University hospital. Patients with known heart, kidney, liver and hematological diseases, peptic ulcer and gastrointestinal bleeding, with allergic reaction to non-steroid anti-inflammatory drugs and chronic pain history and those who received analgesics in the last 24 hours were not included into the study. The patients were assigned to four groups according to a computer generated randomisation list by an independent anesthesiologist. Patients from group 50/0 got 50 mg dexketoprofen 30 minutes prior to the operation; patients from group 0/50 got 50 mg dexketoprofen 30 minutes before the end of the operation and patients from group 25/25 got 25 mg dexketoprofen both 30 minutes prior and 30 minutes before the end of the operation. Dexketoprofen was not applied to any of the patients from group C. Drug preparation, anestesia induction and maintenance and postoperative assesment were done by an anesthesiologist who did not known the patients’ group. All patients were administered patient-controlled analgesia. The patients’ visual analog scale (VAS), intraoperative and postoperative opioid consumption were primary outcomes. Patient satisfaction, sedation, nausea and vomiting and dyspepsia complaints were secondary outcomes and were recorded at 1, 2, 3, 4, 5, 6, 7, 8, 12 and 24 hours . Results: The VAS, nausea and vomiting, sedation and patient satisfaction scores were lower in patients from all groups that had received dexketoprofen compared to the controls. There was no difference in intraoperative fentanyl consumption between the groups. The consumption of tramadol was significantly higher in group C compared to all other groups. Conclusions: Dexketoprofen provides good postoperative analgesia and patient satisfaction if applied intravenously to septorhinoplasty patients. However, there is no significant difference between preoperative and intraoperative applications of dexketoprofen.