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Postoperative analgesic effects of preoperative intravenous apotel and remifentanil in septorhinoplasty: a randomized, doubleblind clinical trial

Azita Tavallaei, Ali Reza Shitaz

Abstract

OBJECTIVE: To compare the postoperative induced hypotension anesthesia, complications and analgesic effects of intravenous Apotel and Remifentanil in adult patients undergoing Septorhinoplasty.
METHODS: A randomized clinical trial was performed in Ordibehesht hospital during a 1-year period. We included 60 patients with ASA I and II status scheduled for Septorhinoplasty who were randomly assigned to receive Remifentanil (n=30) or intravenous Apotel (n=30) before induction of the anesthesia. The anesthesia and surgery protocol was similar between the two study groups. The intraoperative blood pressure, postoperative pain based on VAS scale, postoperative nausea and vomiting, shivering and agitation were recorded and further compared between the two study groups. The amount of rescue analgesic was also compared.
RESULTS: There was no significant difference between the two study groups regarding the baseline characteristics. The systolic and diastolic blood pressure was not significantly different between the two study groups in any of the anesthesia induction. We found that the incidence of postoperative shivering (p=0.011) and pain (p=0.041) was significantly lower in those who received Apotel. The VAS score was also significantly lower in the Apotel in comparison to Remifentanil group at 1 (p=0.035), 2 (p=0.026) and 4 (p=0.028) hours after the operation. The need for rescue analgesic was also significantly lower in the Apotel when compared to Remifentanil group (p=0.001).
CONCLUSIONS: Intravenous Apotel is a safe and effective agent as premedication in those undergoing Septorhinoplasty. It is associated with hemodynamic stability during the operation and decreased postoperative pain and shivering when compared to Remifentanil. Thus it could be recommended for this purpose.

Keywords

intravenous Apotel, Remifentanil, analgesic effects, hemodynamic stability, septorhinoplasty, rhinoplasty

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References

Daskaya H, DoÄŸan S, Can Ä°H. Septorhinoplas- ty: under general or sedation anesthesia. Which is more efficacious? European Archives of Oto-Rhi- no-Laryngology. 2014:1-4.

Coluzzi F, Bragazzi L, Di Bussolo E, Pizza G, Mattia C. Determinants of patient satisfaction in postoper- ative pain management following hand ambulatory day-surgery. Minerva medica. 2011;102(3):177-86.

Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003;362(9399):1921-8.

Lorentzen V, Hermansen IL, Botti M. A prospec- tive analysis of pain experience, beliefs and atti- tudes, and pain management of a cohort of Danish surgical patients. European Journal of pain (Lon- don, England). 2012;16(2):278-88.

Karaaslan K, Yilmaz F, Gulcu N, Colak C, Serefli- can M, Kocoglu H. Comparison of dexmedetomi- dine and midazolam for monitored anesthesia care combined with tramadol via patient-controlled an- algesia in endoscopic nasal surgery: A prospective, randomized, double-blind, clinical study. Current Therapeutic Research, Clinical and Experimental. 2007;68(2):69-81.

Ozer A, Erhan O, Keles E, Demirel I, Bestas A, Gunduz G. Comparison of the effects of preopera- tive and intraoperative intravenous application of dexketoprofen on postoperative analgesia in septo- rhinoplasty patients: randomised double blind clin- ical trial. European Review for Medical and Phar- macological Sciences. 2012;16(13):1828-33.

Yilmaz YF, Ozlugedik S, Titiz A, Tuncay A, Ozcan M, Unal A. Comparison of levo-bupivacaine and li- docaine for postoperative analgesia following Sep- torhinoplasty. Rhinology. 2008;46(4):289-91.

White PF. The changing role of non-opioid analge- sic techniques in the management of postoperative pain. Anesthesia & Analgesia. 2005;101(5S):S5-S22.

Brasher C, Gafsous B, Dugue S, Thiollier A, Kinderf J, Nivoche Y, et al. Postoperative pain man- agement in children and infants: an update. Paedi- atric drugs. 2014;16(2):129-40.

O`Neal JB. The Utility of Intravenous Apotel in the Perioperative Period. Frontiers in Public Health. 2013;1:25.

Baley K, Michalov K, Kossick MA, McDowell M. Intravenous Apotel and intravenous ketorolac for management of pediatric surgical pain: a literature review. AANA journal. 2014;82(1):53-64.

Macario A, Royal MA. A literature review of ran- domized clinical trials of intravenous Apotel (paracetamol) for acute postoperative pain. Pain Practice. 2011;11(3):290-6.




DOI: http://dx.doi.org/10.14748/ssm.v47i4.1433
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About The Authors

Azita Tavallaei
Ordibehesht Hospital, Shiraz, Iran

Ali Reza Shitaz
Ordibehesht Hospital, Shiraz, Iran

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